-
BMJ Clinical Evidence May 2008Acne vulgaris affects over 80% of teenagers, and persists beyond the age of 25 years in 3% of men and 12% of women. Typical lesions of acne include comedones,... (Review)
Review
INTRODUCTION
Acne vulgaris affects over 80% of teenagers, and persists beyond the age of 25 years in 3% of men and 12% of women. Typical lesions of acne include comedones, inflammatory papules, and pustules. Nodules and cysts occur in more severe acne and can cause scarring and psychological distress.
METHODS AND OUTCOMES
We conducted a systematic review and aimed to answer the following clinical question: What are the effects of topical and oral treatments in people with acne vulgaris? We searched: Medline, Embase, The Cochrane Library and other important databases up to June 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).
RESULTS
We found 67 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.
CONCLUSIONS
In this systematic review we present information relating to the effectiveness and safety of the following interventions: topical treatments (adapalene, azelaic acid, benzoyl peroxide, clindamycin, erythromycin (alone or plus zinc), isotretinoin, tetracycline, tretinoin), and oral treatments (doxycycline, isotretinoin, lymecycline, minocycline, oxytetracycline, tetracycline).
Topics: Acne Vulgaris; Benzoyl Peroxide; Clindamycin; Erythromycin; Humans; Isotretinoin
PubMed: 19450306
DOI: No ID Found -
JSES International Jul 2022is a common pathogen leading to postoperative shoulder infections. Many centers are utilizing 5% topical benzoyl peroxide (BPO) gel to decrease cutibacterium acnes...
BACKGROUND
is a common pathogen leading to postoperative shoulder infections. Many centers are utilizing 5% topical benzoyl peroxide (BPO) gel to decrease cutibacterium acnes bioburden prior to surgery. The purpose of this study was to evaluate patient compliance, tolerance, and side effects of applying BPO to the shoulder prior to surgery. Our hypothesis was that BPO would be well tolerated with few, minor side effects, and patients would comply with a regimen of 5 treatments spanning 48 hours prior to surgery.
METHODS
All patients undergoing operative intervention, either open or arthroscopic, about the shoulder from August 7, 2020, through July 15, 2021, by a single surgeon were instructed to apply BPO to the shoulder after showering, on dry skin, in the morning and evening, starting 48 hours before their surgical date. Patients were instructed to apply a half-dollar-sized quantity for each treatment. There were a total of 5 topical applications. On the day of surgery, patients were given a 6-question survey regarding side effects experienced, BPO treatments missed, ease of treatment, and a scenario question. Demographic information was collected, and a satisfaction survey was administered upon study completion.
RESULTS
A total of 183 patients out of a possible 284 eligible patients (64.4%) completed the survey. The median (interquartile range) age at surgery was 59.9 years. Sixty-four participants (35%) in the study cohort were female. One-hundred thirteen (61.7%) had an arthroscopic surgical approach, whereas 70 (38.3%) underwent open shoulder surgery. Most patients (N = 152, 83.5%) experienced no side effects from the topical 5% BPO gel treatments. Twenty-two (12.0%) patients missed 1 treatment, 10 (5.5%) missed 2 treatments, 1 (0.5%) missed 3 treatments, 3 (1.6%) missed 4 treatments, and 4 (2.2%) missed all 5 treatments. The majority of patients, 143 (78.1%), completed all 5 treatments. When prompted to choose between serial skin preparation treatments at home leading up to surgery or a single light-based decolonization procedure in the preoperative holding area on the day of surgery, 111 (60.7%) preferred to undergo antimicrobial treatment at home and arrive for surgery as otherwise scheduled.
CONCLUSION
Serial preoperative applications of topical 5% BPO gel are well tolerated by the majority of patients. Over 20% of patients missed at least one application of BPO. Most patients prefer home-based antimicrobial treatments compared with arriving earlier on the day of surgery for a single light-based antimicrobial treatment.
PubMed: 35813137
DOI: 10.1016/j.jseint.2022.02.009 -
The Journal of Dermatological Treatment Dec 2023Using a three-pronged acne treatment approach-combining an antibiotic, antimicrobial agent, and retinoid-may provide greater efficacy than monad or dyad treatments.... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Using a three-pronged acne treatment approach-combining an antibiotic, antimicrobial agent, and retinoid-may provide greater efficacy than monad or dyad treatments. Herein are the dermal sensitization, irritation, safety, and tolerability results from phase 1 and 2 studies of fixed-dose clindamycin phosphate 1.2%/benzoyl peroxide (BPO) 3.1%/adapalene 0.15% (IDP-126) polymeric mesh gel.
METHODS
Two phases 1, single-blind, vehicle-controlled dermal safety studies were conducted in healthy participants aged ≥18 years. One phase 2 (NCT03170388) double-blind, randomized, parallel-group, and vehicle-controlled study was conducted over 12 weeks in participants aged ≥9 years with moderate-to-severe acne.
RESULTS
A total of 1,020 participants (IDP-126 gel, vehicle, or 1 of the 3 dyad gels [phase 2 only]) were included across the 3 studies (safety populations: = 1,004). In the phase 1 studies, IDP-126 had no confirmed sensitization or contact dermatitis. IDP-126 (deemed "moderately irritating") was significantly less irritating than commercially available BPO 2.5%/adapalene 0.3% gel.
CONCLUSIONS
The results from these three studies show that the triple-combination IDP-126 had a positive safety profile and was well tolerated in healthy participants and those with moderate-to-severe acne.
Topics: Humans; Adolescent; Adult; Adapalene; Peroxides; Single-Blind Method; Benzoyl Peroxide; Acne Vulgaris
PubMed: 37341243
DOI: 10.1080/09546634.2023.2220446 -
Archives of Dermatological Research Dec 2023Microencapsulation has received extensive attention because of its various applications. Since its inception in the 1940s, this technology has been used across several... (Review)
Review
Microencapsulation has received extensive attention because of its various applications. Since its inception in the 1940s, this technology has been used across several areas, including the chemical, food, and pharmaceutical industries. Over-the-counter skin products often contain ingredients that readily and unevenly degrade upon contact with the skin. Enclosing these substances within a silica shell can enhance their stability and better regulate their delivery onto and into the skin. Silica microencapsulation uses silica as the matrix material into which ingredients can be embedded to form microcapsules. The FDA recognizes amorphous silica as a safe inorganic excipient and recently approved two new topical therapies for the treatment of rosacea and acne. The first approved formulation uses a novel silica-based controlled vehicle delivery technology to improve the stability of two active ingredients that are normally not able to be used in the same formulation due to potential instability and drug degradation. The formulation contains 3.0% benzoyl peroxide (BPO) and 0.1% tretinoin topical cream to treat acne vulgaris in adults and pediatric patients. The second formulation contains silica microencapsulated 5.0% BPO topical cream to treat inflammatory rosacea lesions in adults. Both formulations use the same amorphous silica sol-gel microencapsulation technology to improve formulation stability and skin compatibility parameters.
Topics: Adult; Humans; Child; Dermatologic Agents; Benzoyl Peroxide; Acne Vulgaris; Tretinoin; Pharmaceutical Vehicles; Rosacea; Nonprescription Drugs; Gels; Treatment Outcome; Drug Combinations
PubMed: 37792034
DOI: 10.1007/s00403-023-02725-z -
Frontiers in Surgery 2023(), a common pathogen, contributes significantly to infections in shoulder surgery. Prevention of shoulder infection is crucial to improve postoperative functional... (Review)
Review
BACKGROUND
(), a common pathogen, contributes significantly to infections in shoulder surgery. Prevention of shoulder infection is crucial to improve postoperative functional recovery and reduce costs. This study aimed to perform a systematic review and meta-analysis to assess the safety and efficacy of 5% benzoyl peroxide (BPO) application in the shoulder to decrease .
METHODS
Three electronic databases were searched as follows: PubMed, Embase, and the Cochrane Library databases. Data extraction for this study was performed by two independent reviewers, and only level I and level II studies were included. The outcome data sources of individual studies were pooled. The fixed-effect model was used to determine the meta-analysis.
RESULTS
There were five level I studies and five level II studies. The results showed that the 5% BPO group had a lower risk of positivity [OR, 0.21 (0.15, 0.30), = 24, < 0.00001]. The pooled analysis results showed that there was no significant difference in the ability of 5% BPO and 5% BPO + clindamycin to reduce . However, the lower rate of adverse events was significantly in favour of the non-BPO group compared with the 5% BPO group.
CONCLUSION
BPO can decrease in the shoulder to prevent infection. However, the combination of BPO and clindamycin does not enhance this effect further.
LEVEL OF EVIDENCE
II, Systematic review and meta-analysis.
PubMed: 36969754
DOI: 10.3389/fsurg.2023.1015490 -
Journal of the American Academy of... Nov 2023A three-pronged acne treatment approach-combining an antibiotic, antibacterial agent, and retinoid-may provide greater efficacy than single/double treatments. Topical...
BACKGROUND
A three-pronged acne treatment approach-combining an antibiotic, antibacterial agent, and retinoid-may provide greater efficacy than single/double treatments. Topical clindamycin phosphate 1.2%/adapalene 0.15%/benzoyl peroxide (BPO) 3.1% gel (IDP-126) is the first fixed-dose triple-combination in development for acne.
OBJECTIVE
To confirm efficacy, safety, and tolerability of IDP-126 gel in acne treatment.
METHODS
Two phase 3, double-blind, 12-week studies randomized participants aged ≥9 years with moderate-to-severe acne (N = 183; N = 180) 2:1 to once-daily IDP-126 or vehicle gel. Co-primary endpoints comprised participants achieving ≥2-grade reduction from baseline in Evaluator's Global Severity Score (EGSS) and clear/almost clear skin (treatment success) and change from baseline in inflammatory/noninflammatory lesion counts. Treatment-emergent adverse events (TEAEs) were assessed.
RESULTS
At week 12, 49.6% and 50.5% of participants achieved treatment success with IDP-126 versus 24.9% and 20.5% with vehicle (P < .01, both). IDP-126 also provided significantly greater reductions in inflammatory/noninflammatory lesions versus vehicle (least-squares mean percent range: 72.7% to 80.1% vs 47.6% to 59.6%; P < .001, all). Most TEAEs were of mild-moderate severity.
LIMITATIONS
Inter-observer bias/variation in acne severity ratings, limited treatment duration, and population differences that may not generalize to real-world populations.
CONCLUSION
The innovative fixed-dose, triple-combination IDP-126 gel was efficacious and well tolerated in 2 clinical studies of participants with moderate-to-severe acne.
PubMed: 37656094
DOI: 10.1016/j.jaad.2022.08.069 -
Indian Journal of Dermatology 2017Acne is a chronic inflammatory skin disease that involves the pathogenesis of four major factors, such as androgen-induced increased sebum secretion, altered... (Review)
Review
Acne is a chronic inflammatory skin disease that involves the pathogenesis of four major factors, such as androgen-induced increased sebum secretion, altered keratinization, colonization of , and inflammation. Several acne mono-treatment and combination treatment regimens are available and prescribed in the Indian market, ranging from retinoids, benzoyl peroxide (BPO), anti-infectives, and other miscellaneous agents. Although standard guidelines and recommendations overview the management of mild, moderate, and severe acne, relevance and positioning of each category of pharmacotherapy available in Indian market are still unexplained. The present article discusses the available topical and oral acne therapies and the challenges associated with the overall management of acne in India and suggestions and recommendations by the Indian dermatologists. The experts opined that among topical therapies, the combination therapies are preferred over monotherapy due to associated lower efficacy, poor tolerability, safety issues, adverse effects, and emerging bacterial resistance. Retinoids are preferred in comedonal acne and as maintenance therapy. In case of poor response, combination therapies BPO-retinoid or retinoid-antibacterials in papulopustular acne and retinoid-BPO or BPO-antibacterials in pustular-nodular acne are recommended. Oral agents are generally recommended for severe acne. Low-dose retinoids are economical and have better patient acceptance. Antibiotics should be prescribed till the inflammation is clinically visible. Antiandrogen therapy should be given to women with high androgen levels and are added to regimen to regularize the menstrual cycle. In late-onset hyperandrogenism, oral corticosteroids should be used. The experts recommended that an early initiation of therapy is directly proportional to effective therapeutic outcomes and prevent complications.
PubMed: 28794543
DOI: 10.4103/ijd.IJD_41_17 -
CMAJ : Canadian Medical Association... Dec 2016
Topics: Acne Vulgaris; Age of Onset; Anti-Bacterial Agents; Benzoyl Peroxide; Dermatologic Agents; Dicarboxylic Acids; Humans; Infant; Male; Retinoids
PubMed: 27873756
DOI: 10.1503/cmaj.160139 -
Clinical, Cosmetic and Investigational... 2015Acne is characterized by primary lesions on the face, chest, and back, and by a variety of other signs and symptoms. In particular, acne inflammatory lesions result from... (Review)
Review
Acne is characterized by primary lesions on the face, chest, and back, and by a variety of other signs and symptoms. In particular, acne inflammatory lesions result from Propionibacterium acnes colonization and are of particular relevance as they can cause permanent scarring. Acne also causes significant psychological morbidity in affected patients. Products currently available for the treatment of acne include systemic and topical treatments. As these products can cause severe side effects, new, innovative therapies are needed. Farmaka Acne Cream (FAC) is a novel, film-forming cream developed to treat mild and moderate acne. In vitro studies have demonstrated that FAC is as effective as 5% benzoyl peroxide in inhibiting growth of P. acnes. In 32 subjects with mild or moderate acne, FAC reduced all the major signs and symptoms of the disease. These included itching, erythema, and scaling, as well as reductions in the numbers of papules, pustules, and open and closed comedones. Acne severity improved in 38% of subjects, while none worsened. FAC was found to be effective in controlling sebum secretion, and was non-comedogenic. Most subjects (90%) reported tolerability as good or very good, while clinical efficacy and cosmetic acceptability were judged as good. For assessment of contact sensitization and photosensitization, FAC was applied daily to the backs of 29 subjects in two symmetric areas for 10 days. Using a solar stimulator, one minimal erythema dose was delivered to one side of the back from days 11 to 13. The four different subareas of treated/untreated and irradiated/nonirradiated and combinations thereof were compared. No cases of contact sensitization or photosensitization were observed, and FAC is considered safe for use in intense sunlight. In vitro and in vivo studies provide evidence for the safety and clinical benefits of FAC, a promising candidate for the treatment of mild and moderate acne.
PubMed: 25914552
DOI: 10.2147/CCID.S82859 -
Polymers Nov 2022: The amount of oxidant (initiator) and reductant (co-initiator) and their ratio have a significant effect on the properties of polymethacrylate bone cement, such as...
: The amount of oxidant (initiator) and reductant (co-initiator) and their ratio have a significant effect on the properties of polymethacrylate bone cement, such as maximum temperature (T), setting time (t) and compressive strength (σ). The increase in the initiating system concentration causes an increase in the number of generated radicals and a faster polymerization rate, which shortens the setting time. The influence of the redox-initiating composition on the course of polymerization (rate of polymerization and degree of double bond conversion) and the mechanical properties of bone cement will be analyzed. : Bone cements were synthesized by mixing a powder phase composed of two commercially available methacrylate copolymers (Evonic) and a liquid phase containing 2-hydroxyethyl methacrylate (HEMA), methyl methacrylate (MMA), and triethylene glycol dimethacrylate (D3). As an initiating system, the benzoyl peroxide (BPO) as an oxidant (initiator) in combination with a reducing agent (co-initiator), N,N-dimethylaniline (DMA), was used. Samples were prepared with various amounts of peroxide BPO (0.05%, 0.1%, 0.2%, 0.3%, 0.5% and 0.7% by weight) with a constant amount of reducing agent DMA (0.5 wt.%), and various amounts of DMA (0.25%, 0.35% and 0.5% by weight) with a constant amount of BPO (0.3 wt.%). The polymerization kinetics were studied by differential scanning calorimetry (DSC). Doughing time and compressive strength tests were carried out according to the requirements of the ISO 5833:2002 standard. : The increase in polymerization rate was due to the increase in the amount of BPO. In addition, the curing time was shortened, as well as the time needed to achieve the maximum polymerization rate. The final conversion of the double bonds in the studied compositions was in the range 74-100%, and the highest value of this parameter was obtained by the system with 0.3 wt.% of BPO. The doughing times for each BPO concentration were in the range of 90-140 s. The best mechanical properties were obtained for the cement following the initiating system concentrations: 0.3 wt.% of BPO and 0.5 wt.% of DMA. Nevertheless, all tested cements met the requirements of the ISO 5833:2002 standard. : Based on the conducted polymerization kinetic studies, the best reaction conditions are provided by an initiating system containing 0.3 wt.% of BPO oxidant (initiator) and 0.5 wt.% of DMA reductant (co-initiator). A decrease in the DMA amount caused a decrease in the polymerization rate and the amount of heat released during the reaction. The change in BPO and DMA concentrations in the composition had little effect on the doughing time of the studied bone cement. The cements showed similar doughing times, ranging from 90-225 s, which is comparable to the bone cement available on the market.
PubMed: 36433131
DOI: 10.3390/polym14225005