Newly Published ROSacea COnsensus (ROSCO) Expert Recommendations Encourage Dermatologists to Upweight Burden-related Discussions, Aim For 'Complete Clearance' of Symptoms and Consider Combination Ther

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

Lausanne, Switzerland (ots/PRNewswire) - Published online in the
British Journal of Dermatology
(https://onlinelibrary.wiley.com/doi/10.1111/bjd.18420), 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, Tübingen 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.

Notes to Editors

About Rosacea

Rosacea is a common inflammatory skin disease that presents
variable clinical characteristics, of which the most common are
flushing, permanent erythema, and inflammatory lesions. It mainly
affects the central areas of the face, such as the cheeks and nose.
The disease can affect both adult men and women, usually after the
age of 30. Additionally, symptoms such as stinging, burning and
increased sensitivity of the skin are common. The eyes are often
affected, and might present as red, dry or itchy.

Although the cause of the disease is still under debate, various
trigger factors are known, including spicy foods, alcohol, emotional
stress, sun/UV-exposure, hot baths and beverages. Demodex, generally
harmless mites, can also be found in the skin in an elevated quantity
in people with rosacea. Rosacea may worsen over time if left
untreated. People that suspect they suffer from rosacea should visit
their dermatologist or healthcare provider for diagnosis and discuss
what treatment is right for them. Because rosacea is a highly visible
disease, it is known to cause embarrassment and anxiety in some
patients, which in turn may cause frustration and have a negative
impact on their social life.

About the Global ROSacea COnsensus (ROSCO) 2019 panel

The Global ROSacea COnsensus (ROSCO) 2019 expert panel included 19
dermatologists from Argentina, Brazil, Canada, France, Germany,
India, Italy, the Netherlands, Qatar, Singapore, South Africa, the
U.K and the U.S.A, and two ophthalmologists from Germany and the
U.S.A. Panel members reached consensus on critical aspects of rosacea
diagnosis and treatment by a modified Delphi approach (e-surveys and
group virtual meeting), by voting on each statement: strongly
disagree, disagree, agree or strongly agree (consensus defined as
>=75% agree/strongly agree). Statements that did not reach consensus
in e-surveys were refined through nominal group discussion at the
meeting and re-voted on. All voting was electronic and blinded.

Galderma funds the creation of ROSCO expert panel meetings and
e-surveys, but is not involved in the voting, discussion or handling
of data.

About the British Journal of Dermatology

The journal is published by Wiley on behalf of The British
Association of Dermatologists, the central association of practising
UK dermatologists. The organization's aim is to continually improve
the treatment and understanding of skin disease. For further
information about the charity, visit www.bad.org.uk.

Wiley is the international scientific, technical, medical, and
scholarly publishing business of John Wiley & Sons, with strengths in
every major academic and professional field and partnerships with
many of the world's leading societies. For more information, please
visit www.wiley.com.

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