Skip to main content
Top
Published in: Dermatology and Therapy 2/2014

Open Access 01-12-2014 | Review

Ingenol Mebutate: A Succinct Review of a Succinct Therapy

Author: David Rhys Alchin

Published in: Dermatology and Therapy | Issue 2/2014

Login to get access

Abstract

Background

Ingenol mebutate is a newly approved topical field therapy for actinic keratosis (AK). It has a dual mechanism of action comprising of a rapid induction of necrosis that specifically targets dysplastic cells, as well as neutrophil-mediated immunostimulatory effects. Such a dual mechanism allows for this agent to clear AK lesions in as little as two to three daily applications, thus providing for improved treatment outcomes and patient satisfaction.

Review

Given that this is a new dermatologic therapy, this review summarizes the key literature surrounding this agent. This review covers the indications for use, mechanisms of action, method of administration, efficacy and safety profile and important drug interactions of ingenol mebutate.

Conclusions

Ingenol mebutate should be considered a highly relevant field therapy for AK and the prevention of progression to squamous cell carcinoma.
Appendix
Available only for authorised users
Literature
1.
go back to reference Berman B, Cockerell CJ. Pathobiology of actinic keratosis: ultraviolet-dependent keratinocyte proliferation. J Am Acad Dermatol. 2013;68(1 Suppl 1):S10–9.PubMedCrossRef Berman B, Cockerell CJ. Pathobiology of actinic keratosis: ultraviolet-dependent keratinocyte proliferation. J Am Acad Dermatol. 2013;68(1 Suppl 1):S10–9.PubMedCrossRef
2.
go back to reference Sotiriou E, Apalla Z, Vrani F, Lallas A, Chovarda E, Ioannides D. Photodynamic therapy vs. imiquimod 5% cream as skin cancer preventive strategies in patients with field changes: a randomized intra individual comparison study. JEADV. 2014. Sotiriou E, Apalla Z, Vrani F, Lallas A, Chovarda E, Ioannides D. Photodynamic therapy vs. imiquimod 5% cream as skin cancer preventive strategies in patients with field changes: a randomized intra individual comparison study. JEADV. 2014.
3.
go back to reference Chia A, Lim A, Shumack S, Moreno G. Actinic keratoses. Aust Fam Phys. 2007;36(7):539. Chia A, Lim A, Shumack S, Moreno G. Actinic keratoses. Aust Fam Phys. 2007;36(7):539.
5.
go back to reference Perl M, Goldenberg G. Field therapy in the treatment of actinic keratosis. Cutis. 2014;93(4):172–3.PubMed Perl M, Goldenberg G. Field therapy in the treatment of actinic keratosis. Cutis. 2014;93(4):172–3.PubMed
6.
go back to reference Dodds A, Chia A, Shumack S. Actinic keratosis: rationale and management. Dermatol Ther (Heidelb). 2014;4(1):11–31.CrossRef Dodds A, Chia A, Shumack S. Actinic keratosis: rationale and management. Dermatol Ther (Heidelb). 2014;4(1):11–31.CrossRef
7.
go back to reference Lebwohl M, Shumack S, Stein Gold L, Melgaard A, Larsson T, Tyring SK. Long-term follow-up study of ingenol mebutate gel for the treatment of actinic keratoses. JAMA Dermatol. 2013;149(6):666–70. Lebwohl M, Shumack S, Stein Gold L, Melgaard A, Larsson T, Tyring SK. Long-term follow-up study of ingenol mebutate gel for the treatment of actinic keratoses. JAMA Dermatol. 2013;149(6):666–70.
8.
go back to reference Siller G, Rosen R, Freeman M, Welburn P, Katsamas J, Ogbourne SM. PEP005 (ingenol mebutate) gel for the topical treatment of superficial basal cell carcinoma: results of a randomized phase IIa trial. Australas J Dermatol. 2010;51(2):99–105.PubMedCrossRef Siller G, Rosen R, Freeman M, Welburn P, Katsamas J, Ogbourne SM. PEP005 (ingenol mebutate) gel for the topical treatment of superficial basal cell carcinoma: results of a randomized phase IIa trial. Australas J Dermatol. 2010;51(2):99–105.PubMedCrossRef
9.
go back to reference Gupta AK, Paquet M. Ingenol mebutate: a promising treatment for actinic keratoses and nonmelanoma skin cancers. J Cutan Med Surg. 2013;17(3):173–9.PubMed Gupta AK, Paquet M. Ingenol mebutate: a promising treatment for actinic keratoses and nonmelanoma skin cancers. J Cutan Med Surg. 2013;17(3):173–9.PubMed
10.
go back to reference Anderson L, Schmieder GJ, Werschler WP, Tschen EH, Ling MR, Stough DB, et al. Randomized, double-blind, double-dummy, vehicle-controlled study of ingenol mebutate gel 0.025% and 0.05% for actinic keratosis. J Am Acad Dermatol. 2009;60(6):934–43.PubMedCrossRef Anderson L, Schmieder GJ, Werschler WP, Tschen EH, Ling MR, Stough DB, et al. Randomized, double-blind, double-dummy, vehicle-controlled study of ingenol mebutate gel 0.025% and 0.05% for actinic keratosis. J Am Acad Dermatol. 2009;60(6):934–43.PubMedCrossRef
11.
go back to reference Rosen RH, Gupta AK, Tyring SK. Dual mechanism of action of ingenol mebutate gel for topical treatment of actinic keratoses: rapid lesion necrosis followed by lesion-specific immune response. J Am Acad Dermatol. 2012;66(3):486–93.PubMedCrossRef Rosen RH, Gupta AK, Tyring SK. Dual mechanism of action of ingenol mebutate gel for topical treatment of actinic keratoses: rapid lesion necrosis followed by lesion-specific immune response. J Am Acad Dermatol. 2012;66(3):486–93.PubMedCrossRef
12.
go back to reference Samrao A, Cockerell CJ. Pharmacotherapeutic management of actinic keratosis: focus on newer topical agents. Am J Clin Dermatol. 2013;14(4):273–7.PubMedCrossRef Samrao A, Cockerell CJ. Pharmacotherapeutic management of actinic keratosis: focus on newer topical agents. Am J Clin Dermatol. 2013;14(4):273–7.PubMedCrossRef
13.
go back to reference Fidler B, Goldberg T. Ingenol mebutate gel (picato): a novel agent for the treatment of actinic keratoses. Pharm Ther. 2014;39(1):40–6. Fidler B, Goldberg T. Ingenol mebutate gel (picato): a novel agent for the treatment of actinic keratoses. Pharm Ther. 2014;39(1):40–6.
14.
go back to reference Stahlhut M, Bertelsen M, Hoyer-Hansen M, Svendsen N, Eriksson AH, Lord JM, et al. Ingenol mebutate: induced cell death patterns in normal and cancer epithelial cells. JDD. 2012;11(10):1181–92.PubMed Stahlhut M, Bertelsen M, Hoyer-Hansen M, Svendsen N, Eriksson AH, Lord JM, et al. Ingenol mebutate: induced cell death patterns in normal and cancer epithelial cells. JDD. 2012;11(10):1181–92.PubMed
15.
go back to reference Ersvaer E, Kittang AO, Hampson P, Sand K, Gjertsen BT, Lord JM, et al. The protein kinase C agonist PEP005 (ingenol 3-angelate) in the treatment of human cancer: a balance between efficacy and toxicity. Toxins. 2010;2(1):174–94.PubMedCentralPubMedCrossRef Ersvaer E, Kittang AO, Hampson P, Sand K, Gjertsen BT, Lord JM, et al. The protein kinase C agonist PEP005 (ingenol 3-angelate) in the treatment of human cancer: a balance between efficacy and toxicity. Toxins. 2010;2(1):174–94.PubMedCentralPubMedCrossRef
16.
go back to reference Fallen RS, Gooderham M. Ingenol mebutate: an introduction. Skin Ther Lett. 2012;17(2):1–3. Fallen RS, Gooderham M. Ingenol mebutate: an introduction. Skin Ther Lett. 2012;17(2):1–3.
17.
go back to reference Siller G, Gebauer K, Welburn P, Katsamas J, Ogbourne SM. PEP005 (ingenol mebutate) gel, a novel agent for the treatment of actinic keratosis: results of a randomized, double-blind, vehicle-controlled, multicentre, phase IIa study. Australas J Dermatol. 2009;50(1):16–22.PubMedCrossRef Siller G, Gebauer K, Welburn P, Katsamas J, Ogbourne SM. PEP005 (ingenol mebutate) gel, a novel agent for the treatment of actinic keratosis: results of a randomized, double-blind, vehicle-controlled, multicentre, phase IIa study. Australas J Dermatol. 2009;50(1):16–22.PubMedCrossRef
18.
go back to reference Lebwohl M, Swanson N, Anderson LL, Melgaard A, Xu Z, Berman B. Ingenol mebutate gel for actinic keratosis. New Engl J Med. 2012;366(11):1010–9.PubMedCrossRef Lebwohl M, Swanson N, Anderson LL, Melgaard A, Xu Z, Berman B. Ingenol mebutate gel for actinic keratosis. New Engl J Med. 2012;366(11):1010–9.PubMedCrossRef
19.
go back to reference Dosik JS, Damstra M, Udell C, Welburn P. Evaluation of the skin sensitization, photo irritation, and photoallergic potential of ingenol mebutate gel in healthy volunteers. J Clin Aesthet Dermatol. 2014;7(4):35–42.PubMedCentralPubMed Dosik JS, Damstra M, Udell C, Welburn P. Evaluation of the skin sensitization, photo irritation, and photoallergic potential of ingenol mebutate gel in healthy volunteers. J Clin Aesthet Dermatol. 2014;7(4):35–42.PubMedCentralPubMed
20.
go back to reference Martin G, Swanson N. Clinical findings using ingenol mebutate gel to treat actinic keratoses. J Am Acad Dermatol. 2013;68(1 Suppl 1):S39–48.PubMedCrossRef Martin G, Swanson N. Clinical findings using ingenol mebutate gel to treat actinic keratoses. J Am Acad Dermatol. 2013;68(1 Suppl 1):S39–48.PubMedCrossRef
Metadata
Title
Ingenol Mebutate: A Succinct Review of a Succinct Therapy
Author
David Rhys Alchin
Publication date
01-12-2014
Publisher
Springer Healthcare
Published in
Dermatology and Therapy / Issue 2/2014
Print ISSN: 2193-8210
Electronic ISSN: 2190-9172
DOI
https://doi.org/10.1007/s13555-014-0061-2

Other articles of this Issue 2/2014

Dermatology and Therapy 2/2014 Go to the issue