Department of Dermatology, Toranomon Hospital, Tokyo, Japan.
Department of Dermatology, Acne Clinical Research Center, Meiwa Hospital, Nishinomiya, Japan.
J Dermatol. 2018 Aug;45(8):951-962. doi: 10.1111/1346-8138.14497. Epub 2018 Jun 15.
Adapalene 0.1% (ADA) with clindamycin phosphate 1.2% (CLNP; ADA + CLNP) and the fixed-dose combination containing CLNP and benzoyl peroxide 3% (CLNP/BPO 3%) are strongly recommended for the early treatment of acne vulgaris in Japan. Here, we compare the early efficacy and safety of CLNP/BPO 3% with Japanese standard topical use of ADA + CLNP in the treatment of acne vulgaris. In this phase IV, multicenter study, 351 patients were randomized to receive CLNP/BPO 3% or ADA + CLNP for 12 weeks. The primary end-point was percentage change from baseline in total lesion (TL) counts at week 2. Secondary end-points included the percentage change from baseline in TL, inflammatory and non-inflammatory lesion (IL and non-IL) counts, Investigator's Static Global Assessment (ISGA), quality of life (QoL [Skindex-16]) and patient preference. Local tolerability scores and adverse events were also recorded. CLNP/BPO 3% provided a significantly greater percentage reduction from baseline in TL compared with ADA + CLNP at week 2, and week 4. Compared with ADA + CLNP, CLNP/BPO 3% was superior at reducing IL (but not non-IL) over weeks 2-12, was more effective at improving patient QoL and ISGA, and scored higher in patient-preference assessments. Both treatments were well tolerated; adverse drug reactions occurred more frequently in patients receiving ADA + CLNP (37%) than in those receiving CLNP/BPO 3% (17%). In conclusion, CLNP/BPO 3% showed greater efficacy for the early treatment of acne vulgaris in Japan, with a more favorable safety profile compared with ADA + CLNP.
阿达帕林 0.1%(ADA)联合克林霉素磷酸酯 1.2%(CLNP;ADA+CLNP)和含有 CLNP 和过氧化苯甲酰 3%(CLNP/BPO 3%)的固定剂量组合在日本被强烈推荐用于寻常痤疮的早期治疗。在这里,我们比较了 CLNP/BPO 3%与日本标准局部使用 ADA+CLNP 治疗寻常痤疮的早期疗效和安全性。在这项 IV 期、多中心研究中,351 名患者被随机分配接受 CLNP/BPO 3%或 ADA+CLNP 治疗 12 周。主要终点是第 2 周时总病变(TL)计数相对于基线的变化百分比。次要终点包括 TL、炎症和非炎症病变(IL 和非-IL)计数相对于基线的变化百分比、研究者静态全球评估(ISGA)、生活质量(Skindex-16[皮肤健康生活质量指数])和患者偏好。局部耐受性评分和不良反应也被记录。CLNP/BPO 3%在第 2 周和第 4 周时提供了相对于 ADA+CLNP 更大的 TL 相对于基线的百分比降低,与 ADA+CLNP 相比,CLNP/BPO 3%在第 2-12 周时能更有效地减少 IL(但不是非-IL),在改善患者生活质量和 ISGA 方面更有效,在患者偏好评估中得分更高。两种治疗方法均具有良好的耐受性;接受 ADA+CLNP 治疗的患者发生不良反应的频率(37%)高于接受 CLNP/BPO 3%治疗的患者(17%)。总之,CLNP/BPO 3%在日本治疗寻常痤疮的早期显示出更好的疗效,与 ADA+CLNP 相比,具有更有利的安全性。