Angiopausin® and Angiopoietin: Unveiling New Mechanisms in Rosacea Treatment through Kinetic Erythema Analysis with the AAREA® Algorithm.

Introduction: Non-transient erythema (NTE) is a major feature of rosacea, but its clinical evaluation is subject to human investigator variability. The angiopoietin-TIE2 receptor tyrosine kinase pathway plays a key role in regulating vascular homeostasis, but was previously overlooked as a target for rosacea therapy. Angiopausin® is a patented plant-based ingredient identified through a molecular phytotherapy screening program as a positive inducer of the angiopoietin-TIE2 pathway, which is the "gatekeeper of vascular quiescence." The objective of this preliminary study was to compare traditional clinical NTE scoring methods with a novel algorithm-assisted approach (AAREA®) aimed at both assessing erythema and exploring the potential scientific interest of analyzing erythema regression patterns in patients with rosacea treated with topical Angiopausin.

Methods: Data were obtained from the regular follow-up of patients with mild-to-moderate rosacea, monitored as part of the real-world "homeostasis in chronic facial dermatosis" registry cohort. Patients were managed exclusively with Angiopausin (applied twice daily) for up to 64 weeks. Facial redness was evaluated clinically using the global investigator erythema assessment (IEA) score and compared to data generated using the algorithm-assisted approach using an ANOVA with post hoc Tukey tests.

Results: Forty-four patients (9 men, 35 women) were included (average follow-up: 29 ± 3 weeks per patient). Reductions in total IEA scores were observed at week 4 (W4; p < 0.05) and through W8 to W64 (p < 0.001). Decreases in individual scores were also observed for flushing, NTE and edema (W4 to W64: p < 0.001), and telangiectasia (W8 to W32; p < 0.001). A high level of agreement (R2 = 0.9566) was observed between the clinical IEA scores and the algorithm-assisted approach. The algorithm-assisted approach also provided quantitative data on redness area and intensity, detected early reductions in NTE, and identified distinctive NTE regression patterns.

Conclusion: This study demonstrated the real-world effectiveness of targeting the angiopoietin-TIE2 pathway for managing rosacea, with topical Angiopausin resulting in significant and long-lasting reductions in NTE and other vascular manifestations. It also highlighted how advances in rosacea therapy can be studied by profiling the clinical effects of treatments using artificial intelligence. The AAREA tool provided valuable data for clinical scoring and research into understanding rosacea pathogenesis.