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Doxcycline plus adapalene/benzoyl peroxide comparable to oral isotretinoin for severe acne

Doxycycline plus adapalene/benzoyl peroxide was found to be comparable to oral isotretinoin in a combined efficacy and safety profile for the treatment of patients with severe nodular acne, according to study results.

Researchers conducted a multicenter, randomized, investigator-blinded study of 266 patients between the ages of 12 and 35 years with severe facial acne vulgaris. Patients were randomly assigned to receive either oral isotretinoin (ISO) or doxycycline 200 mg plus adapalene 0.1%/benzoyl peroxide 2.5% gel (D+A/BPO) for 20 weeks. Visits occurred for screening, baseline and at weeks 2, 4, 8, 12, 16 and 20.

At week 2, D+A/BPO demonstrated a significantly earlier onset of action in the reduction of nodules, papules/pustules and total lesions, according to the researchers. However, the ISO-treated patients had superior reduction in nodules (95.6% vs. 88.7%), papules/pustules (95.2% vs. 79.6%) and total lesions (92.9% vs. 78.2%) compared with the D+A/BPO-treated cohort (all P<.01) at week 20.

Treatment-related adverse events were reported less frequently among the patients in the D+A/PBO treatment arm compared with the ISO-treated cohort (142 AEs in 70 patients vs. 299 AEs in 117 patients, respectively).

The researchers concluded that the combination treatment offers an alternative for patients who are intolerant, unable or unwilling to undergo treatment with ISO.

Disclosure: Tan received investigator fees for the study and has served as an advisor (advisory board), consultant, investigator and speaker for Galderma. Please see the full study for a list of all other authors’ relevant financial disclosures.