title: Clinical evidence for the role of a topical anti-inflammatory agent in comedonal acne: findings from a randomized study of dapsone gel 5% in combination with tazarotene cream 0.1% in patients with acne vulgaris.
abstract: BACKGROUND
  Acne pathogenesis is multifactorial and includes inflammation. Combining drugs targeting multiple components of acne pathogenesis is standard practice.
  
  
  OBJECTIVE
  To assess the safety and efficacy of dapsone gel 5%, an anti-inflammatory agent, in combination with tazarotene cream 0.1% for treatment of acne vulgaris.
  
  
  METHODS
  Patients were randomized to receive combination therapy (dapsone gel 5% twice-daily plus tazarotene cream 0.1% daily) or monotherapy (tazarotene cream 0.1% daily). Efficacy and safety data were collected after 1, 2, 4, 8, and 12 weeks of treatment.
  
  
  RESULTS
  Patients in both arms (n=86, dapsone + tazarotene; n=85, tazarotene) showed significant reductions from baseline in inflammatory, noninflammatory and total lesion counts (P is less than .001 for all). At 12 weeks, patients treated with dapsone plus tazarotene showed a greater reduction from baseline in noninflammatory (comedonal) and total lesion counts than tazarotene-treated patients (noninflammatory, 59.7 percent vs. 46.5 percent, P=.01; total, 63.3% vs. 53.6%, P=.02). The percentage of patients achieving treatment success (an investigator subjective score of 0 [none] or 1 [minimal]) was greater in dapsone plus tazarotene?treated patients (42.2%) than in tazarotene-treated patients (21.8%;P=.01). Both treatments were well tolerated.
  
  
  CONCLUSIONS
  Combination therapy with dapsone gel 5% plus tazarotene cream 0.1% was more effective than tazarotene monotherapy for treatment of comedonal acne. The results suggest that anti-inflammatory agents such as dapsone can effectively treat early stages of acne (both comedonal and noncomedonal) when used in combination with a retinoid.
authors: Center for Dermatology and Laser Surgery, Sacramento, CA 95819, USA. et@deramatologyandlasersurgery.com
authors: Emil
authors: E
authors: Tanghetti
authors: Sunil
authors: S
authors: Dhawan
authors: Lawrence
authors: L
authors: Green
authors: Mark
authors: M
authors: Ling
authors: Jeanine
authors: J
authors: Downie
authors: Marguerite A
authors: MA
authors: Germain
authors: J Scott
authors: JS
authors: Kasteler
authors: Leon
authors: L
authors: Kircik
authors: Michael G
authors: MG
authors: Oefelein
authors: Zoe
authors: Z
authors: Draelos
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003622:Dapsone / Q000009:adverse effects / Q000627:therapeutic use*; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D009539:Nicotinic Acids / Q000009:adverse effects / Q000627:therapeutic use*; D012176:Retinoids / Q000009:adverse effects / Q000627:therapeutic use*; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D005782:Gels; D009539:Nicotinic Acids; D012176:Retinoids; C086827:tazarotene; D003622:Dapsone