Patient and physician satisfaction in an observational study with methyl aminolevulinate daylight-photodynamic therapy in the treatment of multiple actinic keratoses of the face and scalp in 6 European countries

Background: Guidelines recommend treating actinic keratoses (AK) as they are recognized as precursors of invasive squamous cell carcinoma.

Objective: The objective of this study was to collect real-world clinical data on the use of methyl aminolevulinate daylight-photodynamic therapy (MAL DL-PDT) for the treatment of face and scalp AK in Europe.

Methods: A prospective, multicenter, non-interventional study was conducted in 6 European countries in patients receiving a single treatment of MAL DL-PDT for face and/or scalp AK. Patient-reported outcomes were assessed by patient questionnaires at baseline and at 3 months after treatment, efficacy was assessed at 3 months using a 6-point global improvement scale, and adverse events (AE) were recorded at each visit.

Results: Overall, 325 patients were enrolled from 52 investigational centers, 314 of whom attended the 3-month visit. Most patients had multiple lesions (58.4% had >10 lesions) with lesions mainly located on the scalp (60.0%) and/or forehead (54.2%). AK were predominantly grade I (39.4%) or grade II (33.2%) and 10.5% of patients had grade III lesions. The proportions of patients and physicians that were overall satisfied to very satisfied with the MAL DL-PDT treatment were 80.4% and 90.3%, respectively. The vast majority of patients (90.0%) would consider using MAL DL-PDT again if needed. Physician-assessed efficacy at 3 months was at least much improved in 83.5% of patients, with 45.9% of patients requiring no retreatment. Related AEs were reported in 15% of patients.

Conclusion: Use of MAL DL-PDT for multiple face and/or scalp AK resulted in high levels of patient and physician satisfaction in clinical practice in Europe, reflecting the good efficacy and high tolerability of this convenient procedure.