James Q. Del Rosso DO & Associates found an effective combo treatment for Severe Inflammatory Acne. They conducted a study to evaluate the efficacy and safety of a daily regimen of 0.3% adapalene and 2.5% benzoyl peroxide (0.3% A/BPO) gel and oral doxycycline 100 mg twice daily in severe (nonnodulocystic, non-conglobate) inflammatory Acne Vulgaris. At the end of a phase 4, 12-week, single-arm, open label, multi-center investigational study,it was revealed that for patients with severe inflammatory acne (non-nodulocystic/non-conglobate), treatment with adapalene and benzoyl peroxide gel 0.3%/2.5% (Epiduo Forte Gel; Galderma) plus oral doxycycline 100mg twice daily appears to be a safe and effective option . The results of the study appear in Journal of Drugs in Dermatology.
Acne vulgaris (AV) is a common, chronic, inflammatory disorder that usually starts in early adolescence (ultimately affecting approximately 85% of adolescents). Acne treatment guidelines suggest a combination approach with topical therapy including a topical retinoid, benzoyl peroxide and an oral antibiotic, or oral isotretinoin (OI), as first-line treatment options for severe acne vulgaris (AV).
The investigators enrolled 186 patients aged ≥12 years with severe inflammatory acne who were considered candidates for oral isotretinoin (OI) therapy. The primary efficacy endpoint was the reduction in number of inflammatory lesions at the end of the 12-week period.
They found that treatment with the combination gel + oral doxycycline was associated with a 66.2% reduction in inflammatory lesions, a 58.7% reduction in non-inflammatory lesions, and a 62.6% reduction in total lesions at Week 12 vs baseline. Moreover, 37.1% of patients achieved Investigator’s Global Assessment (IGA) success (defined as IGA 0 [clear] or 1 [almost clear]).
At the end of the treatment period, 80.1% of patients were no longer considered candidates for OI. Most of the study patients (90.2%) reported at least moderate improvement in acne vulgaris (AV) (90.2%); 83.2% said they were “satisifed” or “very satisfied” with the combination treatment overall. Skin burning sensation and erythema were the most common treatment-emergent adverse events (AEs) reported.
The authors concluded that “[Adapalene/benzoyl peroxide gel 0.3%/2.5% plus doxycycline] is an effective and safe treatment option for severe inflammatory AV, before starting oral isotretinoin OI treatment, or as an alternative when OI cannot be used”.
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