Abstract
Introduction: Topical therapies are indicated for mild to moderate cases of acne vulgaris. The most commonly used are benzoyl peroxide 2.5% gel and adapalene 0.1% gel. Combination of both BPO-Adaplene in a gel has excellent results with no major side effects and no risk of resistance like antibiotics.
Aim: This study was undertaken to find out the efficacy and safety profile of Benzoyl peroxide-adapalene fixed dose topical combination therapy relative to benzoyl peroxide and adaplene monotherapy in patients of acne vulgaris.
Material & Method: In this comparative study of 90 patients of either sex, aged 12 years or more, with mild to moderate grade of Acne Vulgaris and with lesions restricted over the face were enrolled and were divided into three different groups of 30 each by sealed envelope method. Group A-patients were treated with BPO 2.5% gel, Group B- with adapalene 0.1% gel and Group-C were treated with BPO-Adapalene combination gel. Single night time application of gel was advised to patient for a period of 12 weeks. The patients were followed up at 0, 2, 4, 8, 12 weeks at each visit. The decrease in the total number of (both inflammatory + non-inflammatory) lesions and side effects were noted.
Results: At the end of the 12 weeks treatment, all groups showed significant improvement. The decrease in mean lesion count of group A, group B and group C was 52.6%, 55.2%, and 78.4% respectively at 12th week. Group C had excellent results with better tolerability. Dryness was a common side effect.
Conclusion: Fixed dose combination of adapalene-benzoyl peroxide has greater efficacy for treatment of acne vulgaris with comparatively lesser side effects than monotherapies.
Keywords: Acne vulgaris, Benzoyl Peroxide, Adapalene, BPO-Adapalene , efficacy, side effects.
References
- Bergfeld WF. Topical retinoids in the management of acne vulgaris. J Drug Dev Clin Pract 1996; 8:151-60.
- Zaenglein AL, Graber EM, Thiboutut DM et al. “Acne vulgaris and Acneiform eruptions”. In: Freeberg, Eisen, Wolff, Austen Eds. Fitzpatrick’s Dermatology in general medicine. 7th New York: Mc Graw- Hill, 2008. Vol 1. P.690-700
- Webster GF. Inflammation in acne vulgaris. J Am Acad Derm 1995; 33:247–253.
- Kligman AM. An overview of acne. J Invest Derm1974; 62:268–287.
- Leyden JJ. The evolving role of Propionibacterium acnes in acne. Semin Cutan Med Surg 2001; 20(3):139–143.
- Gollnick H, Schramm M. Topical drug treatment in acne. Dermatology 1998; 196(1):119-25.
- Brogden RN, Goa KL. Adapalene: a review of its pharmacological properties and clinical potential in the management of mild to moderate acne. Drugs 1997; 53:511-9.
- Michel S, Jomard A, Demarchez M. Pharmacology of adapalene. Br J Dermatol 1998; 139(52 Suppl):3-7.
- Vega B, Jomard A, Michel S. Regulation of human monocyte toll-like receptor 2 (TLR2) expression by adapalene [abstract]. J Eur Acad Dermatol Venereol 2002; 16(1 Suppl):123-4.
- Shroot B, Michel S. Pharmacology and chemistry of adapalene. J Am Acad Dermatol 1997; 36(Suppl):S96-103.
- Haider A, Shaw JC. Treatment of acne vulgaris. JAMA 2004; 292:726-35.
- Yeung D, Nacht S, Bucks D, et al. Benzoyl peroxide: percutaneous penetration and metabolic disposition. II. Effect of concentration. J Am Acad Dermatol 9(6):920-4
- Bikowski JB. Clinical experience results with clindamycin 1% benzoyl peroxide 5% gel (Duac) as monotherapy and in combi-nation. J Drugs Dermatol2005;4:164–171.
- Martin B, Meunier C, Montels D, Watts O. Chemical stability of adapalene and tretinoin when combined with benzoyl peroxide in presence and in absence of visible light and ultraviolet radiation. Br J Dermatol 1998; 139(Suppl 52):8–11.
- Leyden JJ.A review of the use of combination therapies for the treatment of acne vulgaris. J Am Acad Dermatol 2003;49:S200-10.
- Wolf JE Jr, Kalpan D, Kraus SJ, Loven KH, Rist T, Swinyer LJ, et al. Efficacy and tolerability of combined topical treatment of acne vulgaris with adapalene and clindamycin: A multicenter, randomized, investigator-blinded study. J Am Acad Dermatol 2003;49:S211-7.
- Thiboutot DM, Weiss J, Bucko A, Eichenfield L, Jones T, Clark S, et al. Adapalene-benzoyl peroxide, a fixed-dose combination for the treatment of acne vulgaris: results of a multicenter, randomized double-blind, controlled study. J Am Acad Dermatol 2007; 57:791–799.
- Gollnick HP, Draelos Z, Glenn MJ, Rosoph LA, Kaszuba A, Cornelison R, et al. Adapalene-benzoyl peroxide, a unique fixed-dose combination topical gel for the treatment of acne vulgaris: a transatlantic, randomized, double-blind, controlled study in 1670 patients. Br J Dermatol 2009; 161:1180–1189.
- Gold LS, Tan J, Cruz-Santana A, Papp K, Poulin Y, Schlessinger J, et al. A North American study of adapalene-benzoyl peroxide combination gel in the treatment of acne. Cutis 2009; 84:110–116.
- Pariser DM, Westmoreland P, Morris A, Gold MH, Liu Y, Graeber M. Long-term safety and efficacy of a unique fixed-dose combination gel of adapalene 0.1% and benzoyl peroxide 2.5% for the treatment of acne vulgaris. J Drugs Dermatol 2007; 6:899–905.
Corresponding Author
Dr Sanjeev Gupta
#B2, MM Medical College Residential Campus, Mullana Ambala India
Telephone No + 91-9812017161, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
DOI: https://dx.doi.org/10.18535/jmscr/v5i11.79
