BMI may not have effect on acne medication efficacy, safety

BMI has no bearing on the efficacy or safety of three topical acne medications, according to a poster presented at AAD VMX 2021.

The post hoc analysis of five phase 3 studies evaluating three topical acne medications — clindamycin phosphate 1.2%/benzoyl peroxide 3.75% gel, tretinoin 0.05% lotion and tazarotene 0.045% lotion — included 3,752 participants aged 9 years or older with moderate to severe inflammatory acne. Treatment continued for 12 weeks.

“Clinicians should feel very confident using any of these three medications with all of the different BMIs. If clinicians had any question or hesitancy about prescribing them on different BMIs, they can now feel comfortable,” Fran E. Cook-Bolden, MD, of Mount Sinai Hospital Center, told Healio.

Cook-Bolden and colleagues categorized participants into three subgroups by BMI: less than 25 kg/m² (underweight/normal), 25 kg/m² to less than 30 kg/m² (overweight) and 30 kg/m² or greater (obese). Inflammatory lesions were comparable across the studies and subgroups, although noninflammatory lesions occurred at a higher rate among participants in the less than 25 kg/m² group.

All patients reacted well to the three medications, with treatment-emergent adverse events largely mild to moderate. BMI had no bearing on the efficacy or safety of the topical medications, although lesion reductions were greater with polymeric emulsion lotion vehicles (tretinoin and tazarotene) vs. gel vehicle. In addition, polymeric emulsion vehicles demonstrated greater improvements in those with a BMI of 30 kg/m² or greater.

“We have data which shows remarkable quality of life improvements in patients from the overweight and obese categories, and effective treatment of acne in these groups appears to be really important for overall well-being,” Cook-Bolden said.

“We really believe that addressing the clinical, social and emotional needs in these patients is paramount, and we were really happy to get those results of quality of life improvements, especially in those subgroups,” she said.