ZYCLARA SUMMARY
ZYCLARA (imiquimod) Cream, 2.5% or 3.75% is intended for topical administration. Each gram contains 25 mg or 37.5 mg of imiquimod, respectively, in a white to faintly yellow oil-in-water cream base consisting of isostearic acid, cetyl alcohol, stearyl alcohol, white petrolatum, polysorbate 60, sorbitan monostearate, glycerin, xanthan gum, purified water, benzyl alcohol, methylparaben, and propylparaben.
Actinic Keratosis
ZYCLARA Cream, 2.5% and 3.75% are indicated for the topical treatment of clinically typical visible or palpable, actinic keratoses (AK), of the full face or balding scalp in immunocompetent adults.
External Genital Warts
ZYCLARA Cream, 3.75% is indicated for the treatment of external genital and perianal warts (EGW)/condyloma acuminata in patients 12 years or older.
Limitations of Use
Imiquimod cream has been evaluated in children ages 2 to 12 years with molluscum contagiosum and these studies failed to demonstrate efficacy [see Use in Specific Populations].
Treatment with ZYCLARA Cream has not been studied for prevention or transmission of HPV.
Unevaluated Populations
The safety and efficacy of ZYCLARA Cream have not been established in the treatment of:
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•urethral, intra-vaginal, cervical, rectal or intra-anal human papilloma viral disease.
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•actinic keratosis when treated with more than one 2-cycle treatment course in the same area.
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•patients with xeroderma pigmentosum.
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•superficial basal cell carcinoma.
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•immunosuppressed patients.
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NEWS HIGHLIGHTS
Published Studies Related to Zyclara (Imiquimod)
Comparison of imiquimod 5% cream versus radiotherapy as treatment for eyelid basal cell carcinoma. [2011.10] BACKGROUND: To compare the efficacy, cosmesis and tolerance of two non-surgical treatments-imiquimod (IMQ) 5% cream and radiotherapy (RT)-to combat periocular nodular basal cell carcinoma (BCC)... CONCLUSIONS: IMQ and RT therapies are effective for treating eyelid nodular BCCs. Cosmesis and functional results were better with IMQ, while tolerability was higher with RT.
Comparison of topical 3% diclofenac sodium gel and 5% imiquimod cream for the treatment of actinic keratoses. [2011.07] BACKGROUND: There is a wide spectrum of treatments available for actinic keratosis (AK). Topical diclofenac sodium and imiquimod are two topical treatments, which are noninvasive, easily applied, well-tolerated and effective. AIM: To compare the effects of topical 3% diclofenac sodium plus hyaluranon (DFS) gel, 5% imiquimod (IMQ) cream, and base cream (BC) in patients with AK... CONCLUSIONS: Although DFS and IMQ each had considerable efficacy in the treatment of AK, the efficacy of DFS seemed to decrease after cessation of treatment. (c) The Author(s). CED (c) 2011 British Association of Dermatologists.
Treatment of vulvar intraepithelial neoplasia with topical imiquimod: seven years median follow-up of a randomized clinical trial. [2011.04] OBJECTIVE: Recently we reported on the efficacy of imiquimod for treating vulvar intraepithelial neoplasia (VIN) in a placebo-controlled, double-blinded randomized clinical trial (RCT). Four weeks after treatment, a complete response was observed in 35% of patients and a partial response in 46%. All complete responders remained disease-free at 12 months follow-up. In the current investigations, we assessed long-term follow-up at least 5 years after the initial RCT... CONCLUSIONS: In case of a complete response, imiquimod is effective in the long-term. Furthermore, patients with a long-term complete response had a significantly better global quality of life than patients who recurred after imiquimod treatment. Copyright (c) 2010 Elsevier Inc. All rights reserved.
Efficacy and safety of imiquimod versus podophyllotoxin in the treatment of anogenital warts. [2011.03] BACKGROUND: Anogenital warts are a common sexually transmitted disease caused by human papillomaviruses. Despite the fact, that imiquimod and podophyllotoxin represent common topical agents, direct comparative studies lack. This work compares the effectiveness and safety of self-applied imiquimod 5% cream and podophyllotoxin 0.5% solution... CONCLUSIONS: The current study, a direct comparison of both, confirms the previously obtained mathematical data, that imiquimod 5% cream and podophyllotoxin 0.5% solution have an identical beneficial effect on anogenital warts and are associated with identical and acceptable side effects. Both substances constitute effective and safe treatments of untreated anogenital warts in immunocompetent individuals.
Complete clearance is sustained for at least 12 months after treatment of actinic keratoses of the face or balding scalp via daily dosing with imiquimod 3.75% or 2.5% cream. [2011.02] OBJECTIVE: Assess long-term, sustained, complete clearance of actinic keratoses after treatment with imiquimod 3.75% or 2.5% cream using two two-week or three-week cycles of daily dosing... CONCLUSION: In subjects with a median of eight to nine baseline actinic keratoses who achieved complete clearance after treatment of the full face or balding scalp with topical imiquimod 3.75% cream, complete clearance of all lesions (baseline, recurrent or new) was sustained in >/= 40 percent of subjects for at least 14 months after the last dose. Clinicaltrials.gov identifier NCT00668733.
Clinical Trials Related to Zyclara (Imiquimod)
Combination Therapy of Topical Imiquimod Plus Multipeptide Vaccination for Cutaneous Metastases of Melanoma [Suspended]
The purpose of the study is to determine 1) the safety of administration of topical 5%
imiquimod cream with or without administration of a peptide-based vaccine in patients with
cutaneous metastases of melanoma and 2) evaluate whether topical imiquimod at sites of
melanoma metastasis, with or without vaccine, increases a) endothelial expression of
E-selectin and b) T cell infiltration.
Imiquimod 3.75% Cream in Combination With Cryotherapy in the Treatment of Hypertrophic Actinic Keratoses [Recruiting]
Actinic keratoses (AK) are common cutaneous lesions associate with chronic ultraviolet
radiation exposure. While most authorities consider AK as a pre-malignant lesion, some
consider it as an incipient squamous cell carcinoma (SCC). In addition, the skin around
clinically obvious AK lesions has been subject to the same chronic ultraviolet exposure,
resulting in genetic damage and mutations, resulting in "field cancerization." Subclinical
AKs may progress to clinical AKs, or even de novo invasive SCCs.
Among the current therapies for the treatment of AK are excisional surgery, cryosurgery,
electrodessication and curettage, topical chemotherapy and light therapies. With
cryotherapy, treated lesion clearance rates at 3 months post-treatment after double-freeze
thaw cryotherapy has been reported to be around 76-88%; Overall lesion clearance rate at
approximately 5 months post-cryosurgery has been reported to be 35-51%.
Imiquimod is a topical immune response modifier and a 5% formulation has been approved for
the treatment of AKs in the US as a 2x/week for 16 week regimen and in Europe as a 3x/week
for 4 week regimen for 1 or 2 courses of therapy. Topical imiquimod treatment may also
reduce subclinical lesions in the treatment area, resulting in fewer "new" AK lesions
developing over the same period of time when compared to focal treatment. In a comparison
of cryosurgery versus imiquimod for the treatment of AKs, Krawtchenko et al reported initial
complete clearance rates of 68 and 85% by clinical assessment, respectively. However, the
treatment field sustained clearance rate was 4% versus 73%, respectively. Tan et al
reported that while application of imiquimod or vehicle following cryosurgery resulted in
comparable target AK clearance rates at 12 weeks of 79% versus 76%, respectively, the
imiquimod group had fewer total AKs and fewer subclinical AKs.
Imiquimod cream at a concentration of 3. 75% has been found in Phase 3 studies to be superior
to placebo cream with respect to clearance of AKs using a regimen of up to 2 packets (250 mg
of cream per packet, 500 mg total) applied daily to the entire face (approximately 200 cm2)
for two 2-week treatment cycles separated by a 2-week no-treatment period. This study aims
to examine the benefit of cryotherapy in combination with imiquimod 3. 75% compared to
cryotherapy alone.
Clinical Study to Evaluate the Bioequivalence of Two Imiquimod Cream 3.75% Formulations in Patients With Actinic Keratosis. [Completed]
The objective of this study is to compare the relative efficacy and safety of the test
formulation Imiquimod 3. 75% Topical Cream to the marketed formulation Zyclara® (imiquimod)
3. 75% Topical Cream in the treatment of actinic keratosis. Both the test and reference
formulations will also be compared to a placebo cream to test for superiority.
Treatment of Actinic Keratoses of the Face With Imiquimod 3.75% Cream Followed by Photodynamic Therapy [Terminated]
The purpose of this study is to explore the effect of treating actinic keratoses of the face
with imiquimod 3. 75% cream followed by photodynamic therapy in comparison to treatment with
imiquimod alone
Topical Imiquimod vs. LEEP for Women With Carcinoma In-situ of the Cervix [Recruiting]
OBJECTIVE: The standard of care for high grade cervical intraepithelial neoplasia grade 2 to
3 (CIN 2-3) has been the excision of the cervical transformation zone by way of a loop
electrosurgical excision procedure (LEEP) or cold knife conization (CKC). However, it has
been recognized that these procedures can increase the risks for pre-term labor in women who
still desire to conceive. Recent studies have shown that medical treatment with Imiquimod, a
topical immune response modulator, has significant effects on histological regression of CIN
2-3 when compared with placebo. The investigators propose that treatment with Imiquimod may
be preferable offering similar outcomes on histological regression when compared with
excision or ablation while potentially avoiding or reducing the number of surgical procedure
that places them at risk for future pregnancies.
Reports of Suspected Zyclara (Imiquimod) Side Effects
Influenza Like Illness (4),
Erythema (3),
Chills (2),
Fatigue (2),
Nausea (2),
DRY Skin (2),
Application Site Discolouration (1),
Lymphadenopathy (1),
Oral Herpes (1),
Basal Cell Carcinoma (1), more >>
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Page last updated: 2011-12-09
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