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5-Fluorouracil Forgiving of Poor Treatment Adherence in Actinic Keratosis: Presented at AAFP By Martha Kerr, BSN SAN DIEGO -- September 22, 2008 -- Although adherence to prescribed topical treatment with 5-fluorouracil (5-FU) 0.5% among patients with actinic keratosis is generally poor, the drug is somewhat forgiving and achieves good responses in these patients, investigators reported here at the American Academy of Family Physicians (AAFP) 2008 Annual Meeting. Lead investigator Brad A. Yentzer, MD, Center for Dermatology Research, Department of Dermatology, Wake Forest University School of Medicine, Winston Salem, North Carolina, presented evidence that showed good response to 5-FU 0.5% even in subjects who were less than 80% adherent to their treatment regimen. Dr. Yentzer and colleagues evaluated treatment efficacy in 20 subjects with moderate to severe actinic keratoses on the face and anterior scalp. Patients were all more than 50 years old. Patients were instructed to apply 5-FU to the affected areas once daily for 4 weeks. The researchers measured efficacy by the decrease in the number of lesions from baseline. Patient assessments were done at baseline and at 2, 4, and 8 weeks. Adherence was monitored by electronic Medication Event Monitor Systems (MEMS) caps. Subjects were not informed of the purpose of the MEMS caps until the end of treatment. Adherence was defined as completing more than 80% of treatment days. Nineteen of the 20 subjects completed the study. Adherence rates ranged from 54% to 100%. Overall mean adherence to once-daily application was 86%. "Adherence to once-daily application of topical 5-FU was high throughout the study," Dr. Yentzer said in an interview. Mean adherence was high, at 92%, during the first week, but decreased to an average of 82% by the end of the study. "Even with somewhat poor adherence, we saw a high treatment response, with about an 80% clearance of lesions, so the treatment is quite forgiving," Dr. Yantzer said. He noted that the sample size was small and added that a larger study population will be needed before definite conclusions on the treatment can be made. Funding for this study was provided by sanofi-aventis. [Presentation title: Treatment of Actinic Keratoses.] E-mail this page to a friend or colleague! To print, use this version