Triple-combination topical outperforms dyad formulations, improving acne within 4 weeks

Key takeaways:

• The triple-combination gel yielded a higher inflammatory lesion reduction (54%-55%) vs. dyad formulations (32%-48%).
• The triple combination also saw higher treatment success rates (8%-12% vs. 3%-8%).

Clindamycin phosphate 1.2%, adapalene 0.15% and benzoyl peroxide 3.1% triple-combination topical surpassed dyad formulations in speed of efficacy for acne, according to a study.

“Patients with acne may not be fully adherent to a treatment regimen and increasing treatment complexity can also impair adherence and clinical outcomes,” Steven R. Feldman, MD, PhD, professor of dermatology, pathology and social sciences and health policy at Wake Forest University School of Medicine, told Healio.

Feldman suggested topicals that offer rapid efficacy may present a solution to this problem with combination therapies coming out on top as a “rational approach for managing acne.”

In this review, Feldman and colleagues evaluated data from 10 phase 2 and phase 3 clinical trials on seven different topical acne combination treatments to see which delivered the earliest improvements, defined as 4 weeks after treatment initiation.

Included in the review were six dyad topicals and one triple-combination topical — clindamycin phosphate 1.2%, adapalene 0.15% and benzoyl peroxide 3.1% (CAB; Cabtreo, Ortho Dermatologics).

Results showed the triple-combination CAB gel yielded the greatest reduction in inflammatory lesions (54%-55%) compared with all dyad-combination topicals, which offered lesion reductions rates that ranged from a low of approximately 32% to a high of 48%.

Similar rates were seen among noninflammatory lesions with CAB gel delivering a 43% to 45% reduction within 4 weeks vs. the approximately 25% to 38% reduction offered by the other topicals.

Across all topicals, treatment success ranged from 4% to 12%; however, they were significantly greater among patients treated with CAB (8%-12%) compared with those treated with dyad formulations (3% to ~8%).

According to Feldman, the triple-combination’s fast-acting abilities surpassing that of all the dyads was surprising, especially when accounting for the adapalene and benzoyl peroxide combination.

“One might have thought that the clindamycin wouldn’t add anything to the dyad of adapalene and benzoyl peroxide given benzyl peroxide’s ability to kill bacteria,” he said. “However, the clinical trials indicate that the triple combination is more effective.”

For more information:

Steven R. Feldman, MD, PhD, can be reached at sfeldman@wakehealth.edu.