Efficacy and Safety of Various Oral Isotretinoin Treatment Regimens in Moderate to Severe Acne Vulgaris: A Prospective, Randomised Controlled, Single-Blinded, Parallel-Group Comparative Study

Background: Acne is a multi factorial disease ranging from a couple of comedones and pustules to severe nodulocystic fulminantacne. Isotretinoin (13-cis-retinoic-acid) drug affect all the factors involved in pathogenesis of acne and approved by Food and Drug Administration in 1982. It causes several dose-dependent mucocutaneous and systemic side effects and cost effectObjective: To assess and compare the efficacy and tolerability of two regimens (daily conventional and pulse dose) in moderate to severe acne vulgaris.Methodology: This is a prospective randomized comparative study in moderate to severe acne vulgaris in Kathmandu Medical College Teaching Hospital. The patients were randomly divided into two groups (A and B). In group A conventional dose of 20 mg of oral isotretinoin was given daily and in group B 20 mg of oral isotretinoin was given thrice (Pulse Dosage in alternate day) in a week for six months. The baseline haematological, biochemical and radiological (lumbosacral spine) was compare on first, third and six month.Results: Seventy-four patients were enrolled with mean age of 21.73 years. Patients with daily regimen show good response throughout the therapy for six months (1st, 3rd 6th months), where as those in pulse therapy show moderate to poor response during early month and gradually improve by end of sixth month. At end of sixth month, both the regimen show good response and was statistically significant.Conclusion: However, the pulse dose regimen makes the treatment more acceptable, for patients with acne than the classical standard daily regimen, in term of side effects and cost effectiveness and patient compliance. Journal of Kathmandu Medical CollegeVol. 7, No. 2, Issue 24, Apr.-Jun., 2018, Page: 68-74

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A randomized, open-label, comparative study of efficacy of low-dose continuous versus low-dose intermittent oral isotretinoin therapy in moderate-to-severe acne vulgaris

National Journal of Physiology Pharmacy and Pharmacology ◽

10.5455/njppp.2017.7.0305804052017 ◽

2017 ◽

pp. 1

Author(s):

Santoshkumar Shetti ◽

Nagesh HN ◽

Nagabushan Hanumantharaya

Keyword(s):

Comparative Study ◽

Low Dose ◽

Acne Vulgaris ◽

Open Label ◽

Severe Acne ◽

Oral Isotretinoin ◽

Isotretinoin Therapy

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A randomized open label comparative study to determine the various side effects and patient satisfaction of low dose continuous versus low dose intermittent oral isotretinoin therapy in moderate to severe acne vulgaris

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20182101 ◽

2018 ◽

Vol 7 (6) ◽

pp. 1169

Author(s):

Santhosh A. Shetti ◽

Nagesh H. N. ◽

Nagabushan Hanumanthaiah

Keyword(s):

Patient Satisfaction ◽

Side Effects ◽

Low Dose ◽

Acne Vulgaris ◽

Once Daily ◽

Severe Acne ◽

Treatment Regimens ◽

Group A ◽

Oral Isotretinoin ◽

Group B

Background: Acne Vulgaris is chronic inflammatory disease of pilosebaceous units. Oral isotretinoin is recommended for moderate to severe acne vulgaris who are not responding satisfactorily to conventional therapies. Recent reports indicate that acne patients have been benefiting from the low dose treatment protocols. However, long term daily use of this drug results in frequent side effects such mucocutaneous and systemic side effects. Our aim was to assess and compare the various side effects and patient satisfaction of oral isotretinoin in low dose continuous and intermittent treatment of moderate to severe acne vulgaris.Methods: This was a prospective randomized open labeled comparative study carried out at outpatient department in the Department of Dermatology in Mandya Institute of Medical sciences, Mandya. Patients with moderate to severe acne were assigned equally (50 subjects each) to one of the two treatment regimens by using block randomization technique, Group A was given low dose continuous regimen-20 mg oral isotretinoin once daily for 4 months and Group B was given low dose intermittent regimen-20 mg oral isotretinoin once daily for 1 week out of every 4 weeks. The patients were followed up every 4th week during the treatment period. The patients were examined and side effects were noted in each visit. A six month follow-up evaluation was done to analyze patient satisfaction.Results: Muco-cutaneous dryness was most common adverse effect noted in both the groups A and B. Itching (42%), Alopecia (44%), Myalgia (36%) were seen most commonly in group A and Acne flaring (47%) was most common with group B. With regard to patient satisfaction, in group A 42% were satisfied and 20% were very satisfied, in group B 36% were satisfied and 14% were very satisfied.Conclusions: Study suggests that, Muco-cutaneous dryness was most common side effect in both treatment regimens. Side effects were more frequent with low dose continuous than low dose intermittent isotretinoin regimen. Patient satisfaction was better in continuous regimen.

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Efficacy and safety of a novel water‐soluble herbal patch for acne vulgaris treatment: a randomized, assessor‐blinds controlled, intra‐individual split‐face comparative study

Dermatologic Therapy ◽

10.1111/dth.14925 ◽

2021 ◽

Author(s):

Kulwipapat Jaturapisanukul ◽

Montree Udompataikul ◽

Silada kanolrungsee ◽

Salinee Rojhirunsakool ◽

Nanticha kamanamool ◽

...

Keyword(s):

Comparative Study ◽

Acne Vulgaris ◽

Water Soluble ◽

Efficacy And Safety ◽

Split Face

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A COMPARATIVE STUDY OF THE EFFICACY AND SAFETY OF 12 % GLYCOLIC ACID CREAM AND 10% AZELAIC ACID CREAM IN THE TREATMENT OF POST ACNE HYPERPIGMENTATION.

10.36106/paripex/8703306 ◽

2021 ◽

pp. 34-35

Author(s):

Archana Rede ◽

Sanjay N. Agrawal ◽

Yoganand Kulkarni

Keyword(s):

Comparative Study ◽

Azelaic Acid ◽

Glycolic Acid ◽

Acne Vulgaris ◽

Inflammatory Disorder ◽

Efficacy And Safety ◽

Common Complication ◽

Pilosebaceous Unit ◽

Inflammatory Lesions ◽

Chronic Inflammatory Disorder

Acne vulgaris is a chronic inflammatory disorder of the pilosebaceous unit that is associated with significant psychosocial repercussions. Post inflammatory hyperpigmentation is a most common complication seen after post acne. Therapeutic goal of treatment include promoting degradation of melanosomes and inhibiting their formation. Patient treated with Azelaic acid / Glycolic acid experienced of significant greater reduction in number of inflammatory lesions. This study focuses on the comparison of efficacy of 12% Glycolic acid and 10% Azelaic acid in treating post acne hyperpigmentation.

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Efficacy and Safety of 25% Trichloroacetic Acid Peel Versus 30% Salicylic Acid Peel in Mild-to-Moderate Acne Vulgaris: A Comparative Study

Dermatology Practical & Conceptual ◽

10.5826/dpc.1103a63 ◽

2021 ◽

pp. 2021063

Author(s):

Surabhi Dayal ◽

Satbir Singh ◽

Priyadarshini Sahu

Keyword(s):

Salicylic Acid ◽

Adverse Effects ◽

Comparative Study ◽

Clinical Efficacy ◽

Trichloroacetic Acid ◽

Acne Vulgaris ◽

Efficacy And Safety ◽

Inflammatory Lesions ◽

Treatment Groups ◽

Proven Efficacy

Background: Both salicylic acid (SA) and trichloroacetic acid (TCA) have proven efficacy with goodsafety profiles in the treatment of acne vulgaris. Objectives: This study compared the clinical efficacy and safety of 25% TCA and 30% SA peels in thetreatment of mild and moderate acne vulgaris. Methods: Patients with mild or moderate acne vulgaris were randomized into 2 groups of 25 personseach, and treated with either the TCA peel or the SA peel at 2-week intervals for 12 weeks. Evaluationof active acne was done by individual lesion counts (comedones, papules and pustules) and calculationof the Michaelsson acne score (MAS). Results: Both peels led to significant decrease in individual lesion counts and MAS compared to baselinevalues, without significant differences between the treatment groups. Thus, the peels had equivalentefficacy against acne vulgaris. The TCA peel was better in treating non-inflammatory lesions,while the SA peel was better for inflammatory lesions, but the differences were not significant. Noserious adverse effects were recorded, but more patients in the TCA peel group experienced burningand stinging sensations. Conclusion: The efficacy of 25% TCA is comparable to that of 30% SA in mild-to-moderate acnevulgaris, but safety and tolerability were better with the SA peel than TCA peel.

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