Efficacy of Acne Vulgaris Topical Treatment is Schedule-Dependent

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Some mild to moderate adverse events were associated with the treatment regimens.
Some mild to moderate adverse events were associated with the treatment regimens.

According to a recent randomized, multi-center study published in the European Journal of Dermatology, the schedule of adalapene 0.1% and benzoyl peroxide 2.5% (A/BPO) treatment influences local tolerance and efficacy in acne vulgaris.

The study investigated the effects of 4 treatment conditions: A/BPO overnight (A/BPO-EN, the standard); A/BPO for 3 hours followed by a rinse off using a study supplied mild cleanser (A/BPO-3h); A/BPO daily overnight followed by application of moisturizer lotion in the morning (A/BPO-moisturizer); and A/BPO every other night (A/BPO-EoN) for the first 4 weeks of a 12-week study. 

The study population was composed of mostly individuals who were Caucasian (80.5%), female (57.7%), and Phototype I-III (81.3%) with an average age of 20.6±6.43 years with mild or moderate acne vulgaris. The study population was divided as such: A/BPO-EN (n=30), A/BPO-3h (n=32), A/BPO-moisturizer (n=29) and A/BPO EoN (n=32). The outcomes of treatments were their effect on dryness, scaling, stinging/burning, and erythema.

The researchers compared dryness and scaling in treatment with the standard (64.3%) vs the A/BPO-moisturizer treatment, which did not worsen dryness or scaling (26.7%, P <.005). A/BPO-EoN regimen (12.5%) demonstrated less worsening of stinging/burning compared with the standard (40%, P <.05). There was a significant difference in the Global Worst Score, after 4 weeks of treatment, between the standard and A/BPO-EoN. 

There was a significant difference in Total Sum Score in the A/BPO-3h group compared with the standard. Local tolerability was reduced in both A/BPO-EoN and A/BPO moisturizer groups. A reduction in median total lesion counts was observed in all groups at week 12. A/BPO-3h showed slightly lower efficacy in comparison with the standard. The participants' satisfaction responses, reported by the Cochran-Mantel-Haenszel test, were favorable regarding the modified regimens. Some mild to moderate adverse events were associated with the treatment regimens.

A limitation of the study was the limited investigator sample size. 

These findings suggest that the schedule of acne vulgaris treatment regimens topical adalapene 0.1% and benzoyl peroxide 2.5% (A/BPO) affects local tolerance and efficacy.

Disclosures: This study was supported by Nestlé Skin Health – Galderma International, France. Please refer to original reference for a full list of authors' disclosures.

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Reference

Tan J, Bissonnette R, Gratton D, Kerrouche N, Canosa JM. The safety and efficacy of four different fixed combination regimens of adalapene 0.1%/benzoyl peroxide 2.5% gel for the treatment of acne vulgaris: results from a randomised controlled studyEur J Dermatol. 2018; 28(4):502-508. doi: 10.1684/ejd.2018.3367

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