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Aldara - Treatment for Actinic Keratosis

Click here to view the A-Detail™ on Aldara™ Cream, 5% (Imiquimod).

This is a part of a new class of drugs called immune response modifiers. Aldara is a new and exciting medication that was originally approved for the treatment of genital warts. It has recently been approved in Canada and the US to treat Actinic Keratosis.

It stimulates both the innate immune response through interferon production as well as acquired immunity by activating T helper 1 cells.

The drug’s effectiveness is in its activation of the anti-tumour factors that can be recalled by immune memory.

Aldara is particularly effective for extensive areas of actinic keratosis that are not easily treated by cryotherapy. It is also an alternative to the use of 5Fu cream or photodynamic therapy, and has proven particularly useful in actinic chelitis.

As an example of it effectiveness, a group of 24 actinic keratosis patients were given Aldara 3 times a week for 2 weeks and twice a week thereafter for 12 weeks: 21 patients had their actinic keratosis clear, and 2 partially cleared.

The ideal frequency of application of Aldara may vary by individual and site. Some cycles of therapy involve drug therapy for 1 month, followed by a break for a month and re-evaluation, sometimes followed by another month’s cycle of treatment. Another group of 25 Actinic keratosis patients followed this pattern using a dosing of twice weekly therapy on the face and scalp for a month, followed by the break, and then another cycle if necessary. 46% cleared their actinic keratosis after 1 cycle, and a second cycle cleared another 36%, for a total of 82% success.

The dose used varies according to the condition and to the patient response. Treatment must be individualized for each patient.