Effect of sequential application of topical adapalene and clindamycin phosphate in the treatment of Japanese patients with acne vulgaris

Abstract

The efficacy of combined therapy with a retinoid and antibiotic for Japanese patients with acne vulgaris remains to be established. Further, maintenance strategies limiting the use of topical retinoids must be identified. The objectives of this study are to determine the efficacy of sequential application of topical adapalene and clindamycin phosphate and to assess the impact of this regimen on patients' quality of life. Sixty-six patients were recruited. The regimen comprised two phases. For the 4-week initial treatment, 1% clindamycin phosphate gel was applied twice daily and 0.1% adapalene gel, once. In the 4-week maintenance phase, patients were randomly assigned to the OD group (adapalene applied once daily) or the TW group (adapalene applied once daily on 2 days per week). The acne severity score, lesion counts, microcomedone count, and sebum amount were measured. Quality of life (QOL) was assessed using Skindex-16. All parameters improved significantly by week 4 of initial treatment. No statistically significant differences were found in the improvement of clinical findings between the groups. All QOL scores improved significantly and did not significantly differ between the groups. Our regimen may enable clinical control of acne in Japanese patients and improve their QOL. For limiting retinoid use, weekly application of adapalene during maintenance is suitable.

Japanese Dermatological Association Guidelines: Guidelines for the treatment of acne vulgaris 2017

“…185 Moreover, another study compared a group applying the drug on consecutive days and a group applying it twice a week during maintenance therapy, showing that this made no difference to clinical effect or QOL. 186 Based on the above, we strongly recommend adapalene 0.1% gel for maintaining remission after inflammation has subsided.…”

Evaluation of adapalene alone versus combination therapy of adapalene with benzoyl peroxide and adapalene with clindamycin in treatment of acne vulgaris: a prospective, observational study

“…20 The higher the score, the more the quality of life is impaired. Based on CADI score the QOL can be graded as not impaired (score 0), mildly impaired (score 1-5), moderately impaired (score 6-10) and severely impaired (score [11][12][13][14][15]. The English and Hindi versions of the CADI were used in accordance with the patient's choice of language.…”

“…9,10 Combinations of adapalene with clindamycin and adapalene with benzoyl peroxide (BPO) have shown efficacy in the treatment of acne. 11,12 Adapalene and BPO have complementary modes of action and synergistic activity. 13 Adapalene has anti comedogenic, comedolytic, and anti-inflammatory properties.…”

Which acne treatment has the best influence on health‐related quality of life? Literature review by the European Academy of Dermatology and Venereology Task Force on Quality of Life and Patient Oriented Outcomes

“…5% benzoyl peroxide twice a day 20 9. Combination of 0.1% topically applied adapalene gel, once daily in the evening and 1% clindamycin phosphate topical gel, twice daily in the morning and evening 25 10. 5% benzoyl peroxide twice a day 20…”

“…24 There were no significant differences in the total mean Skindex-16 scores and mean scores of all three Skindex-16 domains between the once-daily adapalene treatment group and once-daily adapalene on 2 days per week groups at 4 and 8 weeks of the study. 25 Participants treated with clindamycin phosphate 1.2%/benzoyl peroxide 2.5% had significantly greater improvements in all four Acne-QoL domains compared with participants treated with each individual active ingredient and vehicle (P < 0.001) in the study by Webster et al 26 Meanwhile, there was no significant difference in the Acne Quality of Life Scale (AQOL) scores of acne patients treated by clindamycin phosphate 10 mg/mL and benzoyl peroxide 50 mg/mL combination gel and acne patients treated by clindamycin phosphate gel 10 mg/mL or benzoyl peroxide gel 50 mg/mL in the study by Stinco et al 27 There were no significant differences in AQOL between 3% salicylic acid and clindamycin phosphate 1% lotion twice daily (first group) and tretinoin 0.05% cream and clindamycin phosphate 1% lotion twice daily (second group) at baseline and at the end of the study by Babayeva et al 28 No difference between two different tretinoin concentrations according to the Acne-QOLI scores was found in the study on tretinoin pump. 29 The average self-perception and role-social scores of…”