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Auffret N, Ngyen JM, Leccia MT, Claudel JP, Dréno B. TRASS: a global approach to assess the severity of truncal acne. J Eur Acad Dermatol Venereol 2022; 36:897-904. [PMID: 35170810 DOI: 10.1111/jdv.18009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 12/07/2021] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Only a small amount of published data regarding truncal acne is available and no proper tool to assess its severity exists. AIM to provide dermatologists with an easy-to-use tool to assess truncal acne (TRASS, truncal acne severity scale) using a global approach. METHODS A scoring tool that assesses the severity of acne (based on GEA and ECLA scales) on the trunk using a global approach was built, including three subscores: family history, clinical signs and quality of life (QoL). In order to test TRASS, the experts used photos of 47 patients attending their clinics with truncal acne. The ROP (Regression OPtimized) model was applied to assess the diagnosis performance of TRASS and to identify items contributing to the classification of the patients. Internal testing was made to demonstrate the robustness of the model. Correlation analyses between the different items were performed to evaluate the interaction between the different items and their impact on the severity grading of truncal acne. RESULTS Patients with the most severe acne were identified by TRASS. The error level was 6.6% after internal validation and 10.4% when using the median value or the centile 75th (6.6% and 10.4%). Correlation was significant between systemic treatment and scars (p=0.0025) and nodules (p=0.01988) and between location and QoL (p=0.0095). CONCLUSION TRASS is the first global, patient-centred approach to evaluate truncal acne by scoring the importance of each factor independently from its clinical severity. TRASS may allow the practitioner to choose and validate the most suitable therapy together with the patient in order to treat his or her truncal acne successfully and to limit treatment failure.
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Affiliation(s)
| | - J M Ngyen
- Biostatistic and Epidemiology, Inserm U1232, Nantes, France
| | - Marie-Thérèse Leccia
- Department of Dermatology, Allergology and Photobiology, CHU A Michallon, Grenoble, France
| | | | - B Dréno
- UF dermato-cancérologie, CHU Nantes-Hôtel-Dieu, CIC Biothérapie Inserm 05031, Inserm, U1232, Nantes, France
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Bertolani MB, Rodighiero E, Gandolfi M, Lotti T, Pedrazzi G, Puviani M, Milani M, Feliciani C, Satolli F. Efficacy and tolerability of short contact therapy with tretinoin, clindamycin, and glycolic acid gel in acne: A randomized, controlled, assessor-blinded two-center trial: The MASCOTTE study. Dermatol Ther 2021; 34:e14724. [PMID: 33377285 DOI: 10.1111/dth.14724] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/18/2020] [Accepted: 12/22/2020] [Indexed: 11/30/2022]
Abstract
Retinoids and antibiotics topical treatments are commonly used as first line therapy in mild to moderate acne. However, irritant contact dermatitis is a common side effect of topical retinoids. A strategy to increase local tolerability is the "short contact therapy" (SCT) approach, consisting in the application of the product with the complete removal after 30 to 60 minutes using a non-aggressive cleanser. A gel containing tretinoin 0.02%, clindamycin 0.8%, and glycolic acid 4% in polyvinyl alcohol (MP-gel) has shown to be effective as monotherapy in mild to moderate acne with a tolerability profile similar to other topical retinoids. So far, no trials have been performed with this gel comparing the tolerability profile of SCT with standard application therapy (SAT). We conducted a 2-center randomized parallel groups, controlled, assessor-blinded study, comparing MP-gel applied as SCT in comparison with MP-gel used as SAT (The "MASCOTTE" trial). Forty-six subjects (nine men and 37 women, mean age 23 ± 4 years, range 18-31 years) with mild-to-moderate acne were enrolled, after their written informed consent in a randomized, parallel groups controlled, assessor-blinded 8-week trial. Twenty-three were assigned to MP-gel once daily (evening application) using the SCT approach (ie, complete removal of product after 1 hour using a gentle cleanser), and 23 were randomized to the SAT approach with the same gel. The primary endpoint was the evolution of the tolerability score (TS) assessed evaluating four items: erythema, dryness, stinging, and burning, using a 4-point score scale (from 0: no symptom to 3: severe symptom). Secondary endpoints were the evolution of global acne grading system (GAGS) score (range: from 0 to >39) and the investigator global assessment (IGA of acne severity) score (range from 0 to 4). TS was evaluated at 2, 4, and 8 weeks. GAGS and IGA scores were evaluated at baseline and at week eight. At week eight, an efficacy global score (EGS) (from 1: no efficacy to 4: very good efficacy) and a tolerability global score (TGS) (from 1: very low tolerability to 3: very good tolerability) evaluation were also done. All the evaluations were performed by an investigator unaware of treatment groups allocation (SCT or SAT). Thirty-eight subjects (83%) completed the 8-week treatment period. Eight subjects (two in the SCT group and six in the SAT group) dropped out prematurely due to low skin tolerability. In the SCT the TS at week two was 1.3 ± 1.7, in the SAT group TS was significantly higher (3.1 ± 1.7) (P = .028). TS was significantly lower in SCT group vs SAT also at weeks four and eight (P = .01; ANOVA test). The GAGS score at baseline was 19 ± 7 in the SCT group and 23 ± 4 in the SAT group (NS). At week 8 the GAGS score in SCT was significantly reduced to 8.5 ± 2.8 (-55%) (P = .001 vs baseline) and was also significantly lower in comparison with SAT group (8.5 vs 15; P = .0054). The IGA scores at baseline were 1.9 ± 0.6 in SCT and 2.4 ± 0.7 in SAT group. At week eight, in comparison with baseline values IGA score was reduced significantly by 48% in SCT and by 30% in SAT. EGS and TGS were significantly higher (better clinical efficacy and better tolerability) in SCT in comparison with SAT (3.6 ± 0.5 and 2.9 ± 0.3 vs 2.7 ± 0.6 and 1.5 ± 0.7; respectively). This tretinoin, clindamycin, glycolic acid gel, applied as SCT, has shown a better skin tolerability and at least a comparable clinical efficacy in comparison with the standard application modality in the treatment of mild-to-moderate acne. The SCT therefore could be an effective treatment strategy which could improve subjects' compliance and adherence.
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Affiliation(s)
| | - Eleonora Rodighiero
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Marco Gandolfi
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Torello Lotti
- University of Rome G. Marconi, Rome, Italy.,Department of Dermatology and Communicable Diseases, Ministry of Health, First Medical Moscow State University, Higher Education Institution I. M. Sechenov, Moscow, Russia
| | - Giuseppe Pedrazzi
- Department of Medicine and Surgery, Unit of Neuroscience and Interdepartmental Center of Robust Statistics (Ro.S.A.) University of Parma, Parma, Italy
| | - Mario Puviani
- Medica Plus, Outpatient Dermatology Service, Modena, Italy
| | - Massimo Milani
- Medical Department, Cantabria Labs Difa Cooper, Caronno Pertusella, Italy
| | - Claudio Feliciani
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Satolli
- Section of Dermatology, Department of Medicine and Surgery, University of Parma, Parma, Italy.,Dermatologic Unit, University Hospital of Parma, Parma, Italy
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Steinke S, Beikert F, Langenbruch A, Fölster-Holst R, Ring J, Schmitt J, Werfel T, Hintzen S, Franzke N, Augustin M. Measurement of healthcare quality in atopic dermatitis - development and application of a set of quality indicators. J Eur Acad Dermatol Venereol 2018; 32:2237-2243. [DOI: 10.1111/jdv.15074] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/04/2018] [Indexed: 01/14/2023]
Affiliation(s)
- S. Steinke
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
- Department of Dermatology; University Hospital Münster; Münster Germany
| | - F.C. Beikert
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
- Practice Dres. Büttner/Meewes/Faubel; Neumünster Germany
| | - A. Langenbruch
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
| | - R. Fölster-Holst
- Department of Dermatology; University Medical Center Schleswig-Holstein; Kiel Germany
| | - J. Ring
- Department of Dermatology and Allergy; Technical University Munich; Munich Germany
| | - J. Schmitt
- Center for Evidence-based Healthcare; University Hospital Carl Gustav Carus; Dresden Germany
| | - T. Werfel
- Division of Immunodermatology and Allergy Research; Clinic for Dermatology; Allergology and Venerology; Hannover Medical School; Hannover Germany
| | - S. Hintzen
- Department of Dermatology; Bundeswehrkrankenhaus Berlin; Berlin Germany
| | - N. Franzke
- Hautarztpraxis Braunschweig; Braunschweig Germany
| | - M. Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP); University Medical Center Hamburg-Eppendorf (UKE); Hamburg Germany
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Vallerand IA, Lewinson RT, Farris MS, Sibley CD, Ramien ML, Bulloch AGM, Patten SB. Efficacy and adverse events of oral isotretinoin for acne: a systematic review. Br J Dermatol 2017; 178:76-85. [PMID: 28542914 DOI: 10.1111/bjd.15668] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2017] [Indexed: 01/01/2023]
Abstract
Despite many years of clinical use of isotretinoin, a comprehensive review of evidence for isotretinoin therapy in patients with acne is lacking. We searched MEDLINE, Embase, Cochrane Central, relevant web pages and bibliographies for randomized controlled trials in acne evaluating isotretinoin vs. control (placebo or other therapy). Data were extracted and summarized descriptively. Eleven trials were identified (total 760 patients randomized), containing mostly men. Mean treatment ages ranged from 18 to 47·9 years and participants generally had moderate-to-severe acne. Across all trials, isotretinoin therapy reduced acne lesion counts by a clinically relevant amount, and always by a greater amount than control, which was either placebo (two studies), oral antibiotics (seven studies) or other control (two studies). Across trials with an overall low risk of bias, two of three demonstrated statistically significant differences between isotretinoin and control. The frequency of adverse events was twice as high with isotretinoin (751 events) than with control (388 events). More than half of all adverse events were dermatological and related to dryness. Adverse events from isotretinoin causing participant withdrawal from trials (12 patients) included Stevens-Johnson syndrome, cheilitis, xerosis, acne flare, photophobia, elevated liver enzymes, decreased appetite, headaches and depressed mood. This review suggests that isotretinoin is effective in reducing acne lesion counts, but adverse events are common. This study was registered with PROSPERO number CRD42015025080.
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Affiliation(s)
- I A Vallerand
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Leaders in Medicine Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - R T Lewinson
- Leaders in Medicine Program, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - M S Farris
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - C D Sibley
- Division of Dermatology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - M L Ramien
- Division of Dermatology, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - A G M Bulloch
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - S B Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Mathison Centre for Mental Health Research and Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Barbaric J, Abbott R, Posadzki P, Car M, Gunn LH, Layton AM, Majeed A, Car J. Light therapies for acne: abridged Cochrane systematic review including GRADE assessments. Br J Dermatol 2017; 178:61-75. [PMID: 28338214 DOI: 10.1111/bjd.15495] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2017] [Indexed: 01/21/2023]
Abstract
We undertook a Cochrane review of randomized controlled trials (RCTs) evaluating the effects of light-based interventions for acne vulgaris. We searched the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, ISI Web of Science and grey literature sources (September 2015). We used the Grading of Recommendations Assessment, Development and Evaluation Working Group approach to assess the quality of evidence (QoE). We included 71 RCTs (4211 participants, median sample size 31). Results from a single study (n = 266, low QoE) showed little or no difference in effectiveness on participants' assessment of improvement between 20% aminolaevulinic acid (ALA) photodynamic therapy (PDT), activated by blue light, vs. vehicle plus blue light, whereas another study (n = 180) comparing ALA-PDT (red light) concentrations showed that 20% ALA-PDT was no more effective than 15% ALA-PDT but better than 10% and 5% ALA-PDT. Pooled data from three studies (n = 360, moderate QoE) showed that methyl aminolaevulinate PDT, activated by red light, had a similar effect on changes in lesion counts vs. placebo cream with red light. Several studies compared yellow light with placebo or no treatment, infrared light with no treatment, gold microparticle suspension with vehicle and clindamycin/benzoyl peroxide (C/BPO) combined with pulsed dye laser with C/BPO alone. None of these showed any clinically significant effects. Most studies reported adverse effects, but inadequately, with scarring reported as absent, and blistering only in studies on intense pulsed light, infrared light and PDT (very low QoE). Carefully planned studies, using standardized outcome measures and common acne treatments as comparators, are needed.
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Affiliation(s)
- J Barbaric
- Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Zagreb, Croatia
| | - R Abbott
- Welsh Institute of Dermatology, University Hospital of Wales, Cardiff, U.K
| | - P Posadzki
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - M Car
- Department of Primary Care and Public Health, Imperial College London, London, U.K
| | - L H Gunn
- Public Health Program, Stetson University, DeLand, FL, U.S.A
| | - A M Layton
- Department of Dermatology, Harrogate and District NHS Foundation Trust, Harrogate, U.K
| | - A Majeed
- Department of Primary Care and Public Health, Imperial College London, London, U.K
| | - J Car
- Centre for Population Health Sciences, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.,Department of Primary Care and Public Health, Imperial College London, London, U.K
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McGoldrick RB, Theodorakopoulou E, Azzopardi EA, Murison M. Lasers and ancillary treatments for scar management Part 2: Keloid, hypertrophic, pigmented and acne scars. Scars Burn Heal 2017; 3:2059513116689805. [PMID: 29799579 PMCID: PMC5965340 DOI: 10.1177/2059513116689805] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The formation of a wide range of excessive scars following various skin injuries is a natural consequence of healing. Scars resulting from surgery or trauma affect approximately 100 million people per annum in the developed world and can have profound physical, aesthetic, psychological and social consequences. Thus, scar treatment is a priority for patient and physician alike. Laser treatment plays an important role in scar management with additional support from ancillary modalities. Subsequent to part 1: Burns scars, part 2 focuses on our strategies and literature review of treatment of keloid, hypertrophic, pigmented and acne scars where lasers are used in conjunction with other measures, and illustrated with case studies.
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Affiliation(s)
- Rory Boyd McGoldrick
- Welsh Regional Burns, Plastic, Reconstructive Surgery and Laser Unit, Morriston Hospital, Swansea, Wales, UK
| | - Evgenia Theodorakopoulou
- Welsh Regional Burns, Plastic, Reconstructive Surgery and Laser Unit, Morriston Hospital, Swansea, Wales, UK
| | | | - Maxwell Murison
- Welsh Regional Burns, Plastic, Reconstructive Surgery and Laser Unit, Morriston Hospital, Swansea, Wales, UK
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Osman-Ponchet H, Sevin K, Gaborit A, Wagner N, Poncet M. Fixed-Combination Gels of Adapalene and Benzoyl Peroxide Provide Optimal Percutaneous Absorption Compared to Monad Formulations of These Compounds: Results from Two In Vitro Studies. Dermatol Ther (Heidelb) 2016; 7:123-131. [PMID: 27900658 PMCID: PMC5336428 DOI: 10.1007/s13555-016-0159-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Indexed: 12/01/2022] Open
Abstract
Introduction Adapalene 0.1%/benzoyl peroxide 2.5% (0.1% A/BPO) and adapalene 0.3%/BPO 2.5% (0.3% A/BPO) gels are fixed-combination options for the topical treatment of acne. However, the active compounds of these combinations are also available as monads, to be used in association or as monotherapy. These two in vitro studies determined the effect of different treatment regimens on the percutaneous absorption of adapalene (0.1% and 0.3%) gels and BPO 2.5% gel in ex vivo human skin. Methods In vitro percutaneous absorption studies were conducted using full-thickness human skin from six donors. Treatment regimens included the application of 0.1% A/BPO, 0.3% A/BPO, or four free-combination regimens of the monads. Skin samples were incubated for 24 h. Concentrations of adapalene and BPO equivalent (BPO-eq) (i.e. benzoic acid after chemical transformation of BPO) were measured using high-performance liquid chromatography. Comparison of regimens was performed using a bioequivalence criterion (estimated ratio bewteen 0.8 and 1.25). Results The fixed combination 0.3% A/BPO regimen demonstrated more than three times higher absorption of adapalene versus the fixed-combination 0.1% A/BPO. Based on the bioequivalence acceptance criterion, all four free-combination regimens were different from 0.1% A/BPO and 0.3% A/BPO, with higher adapalene release delivered by the fixed combinations versus the free combinations. For BPO-eq, the results showed that the free-combination regimens where adapalene 0.1% was applied first were different from 0.1% A/BPO, with lower BPO-eq release delivered by these regimens compared to the fixed combination. The regimen adapalene 0.3% for 10 h followed by BPO 2.5% delivered lower BPO-eq release compared to the fixed combination. Conclusion The fixed-combination A/BPO gels provide optimal percutaneous absorption of the active compounds compared to free combinations of adapalene 0.1%, adapalene 0.3%, and BPO 2.5%. The higher concentration of adapalene in the 0.3% A/BPO gel and the resulting higher absorption may explain higher clinical efficacy.
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Affiliation(s)
- Hanan Osman-Ponchet
- Galderma R&D, Les Templiers, 2400 Route des Colles, BP87, 06902, Sophia Antipolis, France.
| | - Karine Sevin
- Galderma R&D, Les Templiers, 2400 Route des Colles, BP87, 06902, Sophia Antipolis, France
| | - Alexandre Gaborit
- Galderma R&D, Les Templiers, 2400 Route des Colles, BP87, 06902, Sophia Antipolis, France
| | - Nathalie Wagner
- Galderma R&D, Les Templiers, 2400 Route des Colles, BP87, 06902, Sophia Antipolis, France
| | - Michel Poncet
- Galderma R&D, Les Templiers, 2400 Route des Colles, BP87, 06902, Sophia Antipolis, France
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Quick Evidence Synopsis. Dermatol Clin 2016. [DOI: 10.1016/j.det.2016.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Stein Gold L, Weiss J, Rueda MJ, Liu H, Tanghetti E. Moderate and Severe Inflammatory Acne Vulgaris Effectively Treated with Single-Agent Therapy by a New Fixed-Dose Combination Adapalene 0.3 %/Benzoyl Peroxide 2.5 % Gel: A Randomized, Double-Blind, Parallel-Group, Controlled Study. Am J Clin Dermatol 2016; 17:293-303. [PMID: 26945741 PMCID: PMC4863916 DOI: 10.1007/s40257-016-0178-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background A need exists for topical treatments in managing more severe inflammatory acne. Objectives The objectives of this study were to evaluate the efficacy and safety of adapalene 0.3 %/benzoyl peroxide 2.5 % (0.3 % A/BPO) topical gel in subjects with moderate and severe inflammatory acne. Methods This was a multicenter, randomized, double-blind, parallel-group study. Randomization was stratified by acne severity (50 % moderate and 50 % severe). Subjects received 0.3 % A/BPO, 0.1 % A/BPO (benchmark), or vehicle (comparator) once daily for 12 weeks. Co-primary efficacy endpoints were success rate at week 12 (the percentage of subjects rated ‘clear’ or ‘almost clear’ with at least a 2-grade improvement on Investigator’s Global Assessment [IGA]) and change in inflammatory (IN) and noninflammatory (NIN) lesion counts from baseline to week 12. Secondary efficacy endpoints were percent changes in IN and NIN lesion counts. Safety endpoints were incidence of adverse events (AEs) and local tolerability signs/symptoms. Results A total of 503 subjects were randomized: 217, 217, and 69 subjects in the 0.3 % A/BPO, 0.1 % A/BPO, and vehicle groups, respectively. For success rate (subjects rated ‘clear’ or ‘almost clear’ with ≥2-grade improvement in IGA), 0.3 % A/BPO was superior to vehicle, with a treatment difference of 22.7 % (33.7 vs. 11.0 %; 95 % confidence interval [CI] 12.8–32.6, p < 0.001). At week 12, 0.3 % A/BPO was superior to vehicle for mean reduction from baseline in IN (27.0 vs. 14.4) and NIN lesion counts (40.2 vs. 18.5), as well as for percentage reduction from baseline in IN (68.7 vs. 39.2 %) and NIN lesion counts (68.3 vs. 37.4 %) (all p < 0.001). Among subjects with severe inflammatory acne (IGA = 4), 0.1 % A/BPO did not reach statistical significance for success rate compared with vehicle (p = 0.443), whereas 0.3 % A/BPO demonstrated significantly greater efficacy (p = 0.029, requiring ≥3-point IGA improvement). Additionally, 0.3 % A/BPO was safe and well-tolerated. Conclusions Results of this clinical trial demonstrate the significantly greater efficacy of adapalene 0.3 % A/BPO topical gel compared with vehicle as well as a good safety profile in the treatment of moderate to severe inflammatory non-nodulocystic acne, which increases patients’ treatment options. Clinicaltrials.gov identifier NCT01880320.
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Sanclemente G, Acosta JL, Tamayo ME, Bonfill X, Alonso-Coello P. Clinical practice guidelines for treatment of acne vulgaris: a critical appraisal using the AGREE II instrument. Arch Dermatol Res 2013; 306:269-77. [DOI: 10.1007/s00403-013-1394-x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Revised: 07/17/2013] [Accepted: 07/22/2013] [Indexed: 01/22/2023]
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Rzany B, Nast A. Acne treatment in the field: how guidelines and other sources can be included in daily practice. J Eur Acad Dermatol Venereol 2013; 27 Suppl 2:2-5. [PMID: 23731194 DOI: 10.1111/jdv.12167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 03/14/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND Acne is a complex disease ranging from mild to very severe. Quality of life can be considerably affected although the impact on the quality of life does not necessarily correlate with the severity of the disease. AIM To show how good external evidence can be used in individual treatment decisions. METHODS Description of four typical case secenarios usining the recommendation of the recent evidence based guidelines and other sources. RESULTS The four quite typical patients presented here (i) a young boy with comedonal acne; (ii) a young black girl with papulopustular acne; (iii) an older boy with conglobate acne; and (iv) a young women with postadolescent papulopustular acne give a range of the possible challenges a dermatologist may face. CONCLUSION How can the best treatment be selected for our patients? By keeping a clear mind, using the available best evidence and taking of course into account individual factors.
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Affiliation(s)
- Berthold Rzany
- RZANY & HUND, Kurfürstendamm 183, Berlin, D-10707, Germany.
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