Branded tretinoin cream bests generic lotion in adult women with acne
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A branded tretinoin lotion with a polymeric emulsion-based vehicle was superior to a generic tretinoin cream in a number of acne outcomes, according to study findings.
“The branded tretinoin lotion that was studied utilized a barrier enhancing polymeric emulsion-based vehicle,” Zoe Diana Draelos, MD, of Dermatology Consulting Services, PLLC, told Healio. “Tretinoin is a retinoid and as such can induce retinoid dermatitis. This retinoid dermatitis is compliance barrier for patients who are prescribed tretinoin for treatment.”
Draelos suggested that this compliance barrier can be overcome with the polymeric emulsion due to reduced irritation and improved barrier function.
“This improves patient compliance and satisfaction with treatment due to the novel state-of-the-art vehicle,” she said. “The generic tretinoin damages the skin barrier. This research was aimed at understanding the merits of a polymer emulsion vehicle in retinoid delivery.”
In the single-center, double-blind, split-face study, Draelos and colleagues compared the branded tretinoin 0.05% lotion (Altreno, Ortho Dermatologics) with the generic formulation in 25 adult women with acne.
Participants were randomly assigned to apply the lotion and the cream to opposite cheeks once daily for 2 weeks, according to the findings.
Results at the end of treatment showed that the side of the face treated with the generic had significantly more erythema (144%), scaling (144%) and dryness (122%) compared with the branded cream-treated side (all, P < .01).
Skin softness, smoothness, radiance and brightness were all 38% to 41% better for the branded product compared with the generic (all, P < .01).
Regarding the use of the products, the range of participants who found the branded cream to be gentle, comfortable/soothing, spreadable, absorbent, not sticky or with minimal residue was 72% to 92%. By comparison, just 8% to 36% of participants felt these traits were superior for the generic product.
Similarly, skin sensations of softness, dryness and dullness were better for the branded product (> 60% agreement) compared with the generic ( 40% agreement).
Overall, around 70% of patients reported a preference of the branded product over the cream.
These findings surprised Draelos and colleagues.
“The blinded subject and investigator data was surprising,” Draelos said. “In dermatology, we traditionally think the skin characteristics of the drug determine tolerability. In this research, we demonstrated that a well-constructed modern vehicle can overcome drug irritation and improve patient tolerability and acceptance.”
With these findings in mind, it may be true that retinoid dermatitis can be worsened by a poorly constructed generic vehicle and improved by a polymeric emulsion branded vehicle, according to Draelos.
“These findings demonstrate that retinoid dermatitis can be minimized by placing tretinoin in a polymeric emulsion,” she said. “This improves patient tolerability and compliance, which ultimately result in a better clinical outcome.”
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