Experts also welcome upsurge in the adoption of a rosacea signs and
symptoms (‘phenotype’) led approach in clinical practice and announce
the launch of prototype clinical tools to support physicians to optimize
rosacea management
Published online in the
British Journal of Dermatology, updated global recommendations from the ROSacea
COnsensus (ROSCO) expert panel call on dermatologists to recognize the
importance of disease burden discussions, recommending the use of four specific
questions to assist these conversations in practice. Additionally, in light of
evidence showing the clinical benefits of patients reaching ‘clear’ (IGA 0)*,
the panel recommends that “complete clearance” of symptoms should be the primary
objective of any treatment regimen to reduce impact on quality of life and
maximize patient satisfaction.1
The rosacea treatment algorithm, developed by ROSCO in 2017, has been updated
with several new recommendations including the use of combination therapy to
benefit severe patients and those presenting with multiple features, in line
with latest clinical evidence.1-3
“Rosacea can sometimes present as a single feature, or more often as a
combination of features. Once we correctly diagnose our patients, and truly
understand their disease burden – both the visible and non-visible impact –
aiming for ‘clear’ (IGA 0) is possible, resulting in improved quality of life,
longer time to relapse, as well as reduced social and productivity burden.” said
ROSCO Panel Co-Chair Prof. Dr. Martin Schaller, Deputy Medical Director,
Department of Dermatology, Tbingen University, Germany. “Given the significant
benefits associated with achieving ‘clear’, it should become best practice to
aim for complete clearance of symptoms, working closely with our patients to
monitor their progress and adjust treatment accordingly.”
ROSCO experts also recognize that previous guidance about transitioning towards
a rosacea signs and symptoms-led approach to diagnosis, has been well received,
with a rise in adoption and advocacy of the phenotype approach+ in standard
clinical practice.1-3
ROSCO expert feedback has also been used to develop the Rosacea Tracker
prototype tool, a clinical checklist to help dermatologists surpass challenges
to implementing the phenotype algorithm in clinical practice. Additional
consensus was gained on 7 patient case studies representing the common rosacea
phenotypes, providing support for dermatologists to identify these phenotypes in
everyday practice.1
“Optimizing management of our rosacea patients is crucial. This new clinical
tool can provide an ongoing record of a patient’s rosacea features and helps
assess changes over time including their impact and treatment response,” said
ROSCO Panel Co-Chair Prof. Dr. Jerry Tan, Adjunct Professor, Western University,
Windsor, Ontario, Canada. “There have not previously been easy-to-use, point of
care tools to assess all rosacea phenotypes. By using the ROSCO recommended
methodology and tools, we aim to improve and advance the care of patients with
this chronic skin disease.”
The latest ROSCO recommendations provide a basis for local guideline development
to further improve the management of rosacea, and thus improve outcomes, for
rosacea patients globally.
* The success of rosacea treatment is usually defined as a score of 1 (‘almost
clear’) or 0 (‘clear’) on the 5-point Investigator Global Assessment (IGA)
scale. Several studies have shown that patients who achieve ‘clear’ (IGA 0), a
complete reduction in symptoms, experience an extended time to relapse and an
improved quality of life compared with patients who are ‘almost clear’ (IGA 1)4
+ A phenotype approach allows for rosacea diagnosis and management according to
a patient’s presenting disease features, rather than grouping into pre-specified
subtypes1
References:
1. Schaller M, et al. Recommendations for rosacea diagnosis, classification
and management: Update from the global ROSacea COnsensus (ROSCO) 2019
panel. Br J Dermatol. 2019 Aug 7. doi: 10.1111/bjd.18420 [Epub ahead of
print].
2. Tan J, et al. Updating the diagnosis, classification and assessment of
rosacea: Recommendations from the global ROSacea COnsensus (ROSCO) panel.
Br J Dermatol. 2016 Oct 8. doi: 10.1111/bjd.15122.
3. Schaller M, et al. Rosacea treatment update: Recommendations from the
global ROSacea COnsensus (ROSCO) panel. Br J Dermatol. 2016 Nov 12. doi:
10.1111/bjd.15173.
4. Webster G et al. J Dermatolog Treat. 2017;28(5):469-474.
