Is switching retinoids a sound strategy for the treatment of acne vulgaris?
Topical retinoids, such as adapalene gel and tazarotene cream, are considered first-line therapy for the treatment of acne vulgaris. Dermatologists often initiate adapalene gel treatment first, due to its good tolerability, followed by a switch to tazarotene cream in an effort to improve or hasten efficacy outcomes. The goal of this study was to compare the efficacy and safety of 2 daily regimens for the treatment of acne: adapalene 0.1% gel for 12 weeks and adapalene 0.1% gel for 6 weeks followed by tazarotene 0.1% cream for 6 weeks. The primary efficacy outcome was the percent of reduction in total lesion counts posttreatment. Subjects ages 12 to 35 years with acne vulgaris were selected to participate in a 12-week, randomized, evaluator-blind study of once-daily therapy with adapalene 0.1% gel (n=101) or "switch therapy," adapalene 0.1% gel followed by tazarotene 0.1% cream (n=100). Adapalene-treated subjects achieved similar percent reductions in total lesion counts at week 12 compared to subjects receiving switch therapy, demonstrating the noninferiority of adapalene gel treatment (median difference: -3.57%; lower confidence limit [LCL]: -11.25). Adapalene gel was associated with fewer reports of cutaneous irritation, particularly for scaling and stinging/burning, and fewer treatment-related adverse events compared to switch therapy. The results of this study indicate that daily therapy with adapalene 0.1% gel for 12 weeks was noninferior to switch therapy.
Henry Ford Medical Center, Detroit, MI, USA.
Linda Stein
LS
Gold
Luz E
LE
Colón
Lori A
LA
Johnson
Ronald W
RW
Gottschalk
D000152:Acne Vulgaris / Q000188:drug therapy* / Q000473:pathology; D000068816:Adapalene; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D002648:Child; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004890:Erythema / Q000139:chemically induced; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D009281:Naphthalenes / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D009539:Nicotinic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012176:Retinoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012867:Skin / Q000473:pathology; D011795:Surveys and Questionnaires
D003879:Dermatologic Agents; D005782:Gels; D009281:Naphthalenes; D009539:Nicotinic Acids; D012176:Retinoids; D000068816:Adapalene; C086827:tazarotene