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Spironolactone use for acne increases
There was a significant increase in the use of spironolactone as therapy for patients with acne by both dermatologists and nondermatologists between 2004 and 2013, according to recently published study results in the Journal of the American Academy of Dermatology.
John S. Barbieri, MD, MBA, of the dermatology department of the University of Pennsylvania Perelman School of Medicine, and colleagues used the OptumInsight Clinformatics DataMart to conduct a retrospective analysis of 572,630 patients (65% female) treated for acne between 2004 and 2013 in the United States.
Of the patients, the median age at time of first available diagnosis of acne was 18 years, and 89% had seen a dermatologist at least once.
There were 594,776 courses of oral antibiotic therapy among 298,439 patients; 527,288 courses of combined oral contraceptive therapy among 284,314 patients; 61,042 courses of spironolactone therapy among 30,855 patients; and 108,664 courses of isotretinoin therapy among 90,870 patients.
Among females, there was an increase of 2.08 to 8.13 courses of spironolactone prescriptions per 100 patients prescribed by dermatologists, a 291% increase during the study period. The prescription rate by nondermatologists increased from 1.43 to 4 per 100 female patients, a 186% increase.
Oral antibiotics had a median duration of therapy of 126 days for patients managed by dermatologists and 129 days for those managed by nondermatologists, with no significant change during the time of study.
“Our study highlights that spironolactone is become an increasingly popular systemic therapy in the treatment of acne among dermatologists as well as among nondermatologists, although it remains relatively infrequently utilized when compared with oral antibiotics,” the researchers wrote. “This growth was most notable among adults. Whereas, we initially observed a slight decrease in oral antibiotic use, this trend has been reversed in recent years.
“Additional work to identify patients who would benefit most from alternative therapies such as spironolactone, oral contraceptives or isotretinoin represents a potential opportunity to improve the care of patients with acne.” – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.