Evaluation of the safety and effectiveness of combination therapy with 1% ivermectin solution in moderate to severe rosacea: a cohort study

<b>Introduction.</b> Rosacea is a common chronic dermatological disease that negatively affects the quality of life of patients.<b>Hypothesis.</b> Combination therapy with 1% ivermectin solution alongside systemic treatment methods is more effective in reducing the severity of moderate to severe papulopustular rosacea symptoms compared with traditional treatment methods alone.<b>Aim.</b> This study is aimed at finding new approaches to the treatment of moderate and severe forms of rosacea.<b>Methodology.</b> This research compared the main group receiving ivermectin with a control group getting conventional treatment to assess the safety and efficacy of 1% ivermectin combination therapy in 70 individuals with moderate to severe rosacea. At weeks 2, 4 and 8, the dynamics of clinical symptoms were evaluated using a 4-point scale.<b>Results.</b> The use of combination therapy with ivermectin led to a more pronounced improvement in the clinical picture. Already at week 4, a 48-54% decrease in symptoms was recorded in the main group, while in the control group, it was only by 25-30%. By week 8, an almost complete reduction of the main manifestations was observed in the main group (78-88% decrease). Regression analysis confirmed that combination therapy with ivermectin was a key factor determining a more substantial clinical improvement, regardless of age, gender and the initial severity of the patient's condition. In addition, a much more pronounced decrease in the number of Demodex ticks was recorded in the main group. The effectiveness of combination therapy with ivermectin did not depend on the demographic or clinical characteristics of patients, which makes it a universal method of treating rosacea. No serious side effects have been reported in any patient receiving combination therapy, which indicates its safety.<b>Conclusion.</b> This approach can be a valuable addition to existing strategies for the treatment of this chronic dermatological disease.