Quality of life in treatment of AK: Treatment burden of ingenol mebutate gel is small and short lasting.

Background: Treatments for actinic keratosis (AK) can elicit adverse local skin responses (LSRs). Knowledge regarding the burden of AK treatment on health related quality of life (HRQoL) is however limited.

Objectives: To investigate whether treatment of AK improved HRQoL; to assess whether LSRs had an impact on HRQoL during treatment and to analyze the relationship between LSRs and HRQoL.

Methods: Patients (n = 329) were randomized for treatment with cryosurgery (CRY) followed by ingenol mebutate (IngMeb) (CRY + IngMeb) or CRY followed by vehicle (CRY + vehicle). HRQoL was analyzed using DLQI, EQ-5D and EQ-VAS at baseline, three days, two weeks and eight weeks post treatment.

Results: Statistically significant HRQoL improvements were seen in all measures in both treatment groups (p < 0.001). Impairments in DLQI in CRY + IngMeb at LSR peak were within a range interpreted as having "a small impact on patients' life" (2-5), which normalized within two weeks.

Limitations: DLQI may not be sensitive to change in the AK disease as it mainly captures symptoms and has a limited focus on feelings.

Conclusion: The treatment burden of IngMeb is small, manageable and short-lasting. Since AK is a chronic condition, often requiring repeated treatment courses, combining treatments that provide enhanced effectiveness, while limiting HRQoL impairment is essential.