Treatment with anti-inflammatory dose doxycycline plus combination adapalene 0.3% and benzoyl peroxide 2.5% gel is safe and effective for the management of severe acne, according to results published in the Journal of Drugs in Dermatology. This combination could be a viable alternative for isotretinoin, which is not suitable for, or appealing to, many patients.

The investigator enrolled 20 patients with severe acne (average age, 19 years; 55% male) in the open-label pilot study. Participants attended study visits at baseline and weeks 4, 8, and 12. Cohort members received doxycycline 40 mg daily and combination adapalene 0.3% and benzoyl peroxide 2.5% gel.

At baseline, all patients had a score of ≥4 (Severe) on the Investigator Global Assessment (IGA), ≥20 inflammatory lesions, ≥20 noninflammatory lesions, and ≤4 nodules. A one-grade IGA improvement was seen in 75% of the patients by week 4; at week 8, 40% of patients had improved two grades to Mild and 10% had a three-grade improvement to Almost Clear. By the final visit, 95% of subjects had at least a two-grade improvement in IGA scores.

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Statistically significant reductions in nodules and inflammatory and noninflammatory lesion counts began at week 4. By week 12, 90% of patients had no nodules, and counts were reduced in 80% and 71% of inflammatory and noninflammatory lesions, respectively. Treatment was well-tolerated with no serious treatment-related adverse events.

“Combination treatment with anti-inflammatory dose doxycycline plus combination adapalene 0.3% and benzoyl peroxide 2.5% gel is safe and effective for management of severe acne,” the investigator concluded.

Disclosure: The author study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of author’s disclosures.

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Reference

Kircik LH. Anti-inflammatory dose doxycycline plus adapalene 0.3% and benzoyl peroxide 2.5% gel for severe acne. J Drugs Dermatol. 2019;18(9):924-927.