INTRODUCTION
Rosacea is a common inflammatory disorder of the facial skin and eyes. It is a disease that may progress with age, and has previously been associated epidemiologically with Northern European descent and environmental factors including dietary factors, alcohol, photo damage, and neurologic stressors.1-3 Rosacea is being increasingly recognized in East Asia as well4 and may occur in patient with darker skin types. From an inflammatory standpoint, it shares some features with acne vulgaris, but tends to affect an older population.5 Clinically, rosacea has traditionally been subdivided into four subtypes. Type 1 rosacea is the most common and is characterized by facial erythema. Type 2 is usually more severe than type 1 and is characterized by papules and pustules. Type 3 is known as rhinophymatous rosacea and may represent the endpoint of chronic type 1 and type 2 rosacea and is often disfiguring. Type 4 rosacea involves the eyes, and is commonly treated concurrently with topical agents and with oral antibiotics such as doxycycline.6 Most patients manifest with more than one subtype and we are moving more to a phenotypic description of the disease.
There is an unmet need for rosacea treatments and especially ones that target more than one manifestation. The most common therapies include topical metronidazole, azelaic acid, ivermectin, and vasoconstrictors such as brimonidine, as well as oral tetracyclines.3,7-9 Each of these treatments is complicated by factors such as low efficacy, rebound, antibiotic resistance, and high pricing for drugs with modest efficacy. Oral antibiotics for non-infectious disorders are coming under increasing scrutiny due to newly discovered effects on the gut and skin microbiome.2 Thus, there is a pressing need for novel therapies for rosacea that impact all components of the disease.
In this report, we evaluate the efficacy and safety of ACU-D1 (Pentaerythritol tetrakis (3-(3, 5-di-tert-butyl-4-hydroxyphenyl) propionate), a novel proteasome inhibitor in a first in human
There is an unmet need for rosacea treatments and especially ones that target more than one manifestation. The most common therapies include topical metronidazole, azelaic acid, ivermectin, and vasoconstrictors such as brimonidine, as well as oral tetracyclines.3,7-9 Each of these treatments is complicated by factors such as low efficacy, rebound, antibiotic resistance, and high pricing for drugs with modest efficacy. Oral antibiotics for non-infectious disorders are coming under increasing scrutiny due to newly discovered effects on the gut and skin microbiome.2 Thus, there is a pressing need for novel therapies for rosacea that impact all components of the disease.
In this report, we evaluate the efficacy and safety of ACU-D1 (Pentaerythritol tetrakis (3-(3, 5-di-tert-butyl-4-hydroxyphenyl) propionate), a novel proteasome inhibitor in a first in human
