Adapalene 0.3% Gel Shows Efficacy for the Treatment of Atrophic Acne Scars

Background After dermatitis, acne is the next skin disease to contribute most to the burden of skin diseases worldwide. Recently, seven core outcome domains have been identified, which together form an Acne Core Outcome Set (ACORN). One of these was satisfaction with acne treatment. Objectives To identify studies that described the development of patient-reported outcome measures (PROMS), evaluated one or more measurement properties of a PROM, or evaluated the interpretability of a PROM in patients with acne regarding treatment satisfaction. Methods The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) search strategy for identifying PROMS on acne treatment satisfaction was used. We searched PubMed, MEDLINE, Embase, LILACS, Web of Science, Cochrane Library, Emcare, PsycINFO and Academic Search premier (June 2020). Study selection, data extraction and assessment of methodological quality according to COSMIN guidance were carried out independently by two authors. Results Only one study could be included, describing the development of a treatment satisfaction measure in patients with acne. The development was assessed as inadequate and data on measurement properties were lacking. Additionally, we found 188 studies reporting treatment satisfaction solely as an outcome, using a wide variety of methods, none of them standardized or validated. Conclusions We could not find a PROM on treatment satisfaction to recommend for a core outcome set in acne. There is an unmet need for a PROM on treatment satisfaction in acne that is robustly developed, designed and validated.What is already known about this topic?• Core outcome sets are consensus-based minimum outcome measures that should be reported in clinical trials of a specific disease or target condition.

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“…Screening of the reference lists of these papers resulted in one additional study, making the total 255. Of these 254 were excluded …”

Section: Resultsmentioning

confidence: 99%

Identifying and appraising patient‐reported outcome measures on treatment satisfaction in acne: a systematic review*

Zuuren

Arents²,

Miklas

et al. 2020

Br J Dermatol

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“…As both photodamaged skin and atrophic acne scars are associated with loss of dermal matrix, A0.3/BPO2.5 may exert a beneficial effect on pre-existing atrophic scars. A phase II pilot study in 20 subjects with a history of acne and moderate to severe acne scars receiving adapalene 0.3% for 24 weeks (once daily for 4 weeks then twice daily for 20 weeks) provided evidence for the improvement of atrophic scars with adapalene 0.3% [ 20 ]. Immunohistochemical analysis showed increased staining for procollagen-1 and collagen-3, supporting a remodeling effect of adapalene 0.3% gel, which was shown to improve skin texture and the appearance of atrophic acne scars, with a significant improvement in global scar grades [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, in our study, the progressive incremental increase in efficacy and effect on scars observed with A0.3/BPO2.5 over 24 weeks highlights the importance of a longer duration of treatment. In fact, 3 months may be sufficient to observe resolution of the primary acne lesions, but the remodeling processes occur slowly, and 6 months may be required to induce significant stimulation of the dermal fibroblasts and collagen and clinically observe an effect on scars [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the well-documented efficacy of topical retinoid treatments for primary lesions of acne, information on the efficacy of these treatments in mitigating acne scars is sparse. An exploratory study demonstrated that adapalene 0.3% gel improved skin texture and the appearance of atrophic acne scars according to investigator and subject global assessment over 24 weeks, which may have been related to enhanced collagen production [ 20 ]. Additionally, in a previous split-face randomized controlled trial over a 24-week period, A0.1/BPO2.5 gel (containing 0.1% adapalene) was shown to reduce the risk of atrophic scar formation in moderate facial acne and improve the overall appearance of global scarring grade [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Prevention and Reduction of Atrophic Acne Scars with Adapalene 0.3%/Benzoyl Peroxide 2.5% Gel in Subjects with Moderate or Severe Facial Acne: Results of a 6-Month Randomized, Vehicle-Controlled Trial Using Intra-Individual Comparison

et al. 2018

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BackgroundVery few clinical trials have investigated the effect of topical acne treatment on scarring.ObjectivesOur objective was to evaluate the efficacy of adapalene 0.3%/benzoyl peroxide 2.5% gel (A0.3/BPO2.5) in atrophic acne scar formation in patients with acne.MethodsIn this multicenter, randomized, investigator-blinded, vehicle-controlled study, subjects with moderate or severe facial acne (Investigator’s Global Assessment [IGA] score 3 or 4; ≥ 25 inflammatory lesions; ten or more atrophic acne scars) applied A0.3/BPO2.5 or vehicle daily per half face for 24 weeks. Subjects with acne requiring systemic treatment were excluded. Assessments included investigator atrophic acne scar count, Scar Global Assessment (SGA), acne lesion count, IGA, skin roughness and skin texture, subject self-assessment of clinical acne-related scars and satisfaction questionnaire, tolerability, and safety.ResultsIncluded subjects (n = 67) had mainly moderate acne (92.5% IGA 3); mean scores at baseline were approximately 40 acne lesions and 12 scars per half face. By week 24, the change from baseline in total scar count was − 15.5% for A0.3/BPO2.5 versus + 14.4% for vehicle (approximately 30% difference), with a mean of 9.5 scars versus 13.3 per half face, respectively (p < 0.0001). For SGA at week 24, a total of 32.9% with A0.3/BPO2.5 versus 16.4% with vehicle (p < 0.01) were clear/almost clear. Inflammatory acne lesions decreased by 86.7% for A0.3/BPO2.5 versus 57.9% for vehicle (p < 0.0001), and 64.2 versus 19.4% of subjects, respectively, were IGA clear/almost clear (p < 0.0001) at week 24. Treatment-related AEs were reported by 20.9% for A0.3/BPO2.5 versus 9% for vehicle side, most commonly skin irritation (14.9 vs. 6%, respectively).ConclusionsTopical A0.3/BPO2.5 prevented and reduced atrophic scar formation. Scar count increased with vehicle (+ 14.4%) but decreased with A0.3/BPO2.5 (− 15.5%) over 24 weeks.Trial registryClinicalTrials.gov identifier NCT02735421.

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“…Retinoids are frequently topically applied to improve several skin conditions. They are known to have an influence on dermal collagen synthesis [1], are utilized to reduce signs of skin aging [2][3][4] and have been shown to provide smooth atrophic acne scars [5,6]. Moreover, retinoids are known to activate fibroblasts, to increase type I procollagen and to decrease matrix metalloproteinase (MMP) expression in skin damaged by ultraviolet (UV) irradiation [1,7], to improve the skin texture and to reduce skin discoloration [8].…”

Section: Introductionmentioning

confidence: 99%

Microneedle-Facilitated Intradermal Proretinal Nanoparticle Delivery

et al. 2020

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Topical retinoid treatments stimulate biological activities in the skin. The main physical barrier, which limits the efficacy of transdermal drug delivery, is the stratum corneum. Proretinal nanoparticles (PRN) have already been proven to efficiently deliver retinal into the epidermis. In the present study, two transdermal drug delivery systems, microneedles (MN) and PRN, were combined to directly target the dermis. The microchannels induced by the MN, the PRN localization in the microchannels and the skin closure kinetics were investigated by non-invasive imaging techniques, such as dermoscopy, optical coherence tomography and multiphoton tomography. Additionally, the amount of retinal in the epidermis and dermis after application in three different forms (PRN-Loaded microneedles, PRN suspension or conventional retinal solution) was compared. All imaging techniques confirmed the formation of microchannels in the skin, which were partly still detectable after 24 h. Multiphoton tomography showed the release of PRN from the MN within the microchannels. The recovered retinal concentration in the dermis was significantly higher when applied via PRN-loaded microneedles. We hypothesized that this platform of PRN-loaded microneedles can provide a rapid and efficient administration of retinal in the dermis and could be of benefit in some skin conditions such as atrophic scar or photo-aged skin.

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Adapalene 0.3% Gel Shows Efficacy for the Treatment of Atrophic Acne Scars

Cited by 30 publications

References 32 publications

Identifying and appraising patient‐reported outcome measures on treatment satisfaction in acne: a systematic review*

Identifying and appraising patient‐reported outcome measures on treatment satisfaction in acne: a systematic review*

Prevention and Reduction of Atrophic Acne Scars with Adapalene 0.3%/Benzoyl Peroxide 2.5% Gel in Subjects with Moderate or Severe Facial Acne: Results of a 6-Month Randomized, Vehicle-Controlled Trial Using Intra-Individual Comparison

Microneedle-Facilitated Intradermal Proretinal Nanoparticle Delivery

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