Maintenance acne therapy: prophylactic efficacy of fixed combination of adapalene and benzoyl peroxide

2020 ◽  
pp. 57-62
Author(s):  
L. S. Kruglova ◽  
N. V. Gryazeva
Keyword(s):  
Maintenance Therapy ◽  
Fixed Combination ◽  
Psychological Impact ◽  
Supportive Therapy ◽  
Prophylactic Efficacy ◽  
Severe Acne ◽  
Topical Retinoids ◽  
Acne Therapy ◽  
Group 2 ◽  
Treatment Observation

Acne is a chronic disease and even reliable therapies do not completely ensure absence of relapses. Acne relapses have a negative psychological impact on patients, as they feel unable to control the disease and achieve complete and long-lasting recovery. Supportive therapy is necessary to prolong the remission of acne achieved with initial successful treatment and to minimize the risk of relapse. According to the literature sources, the most justified as a maintenance therapy is the use of topical retinoids, which have been shown to be effective in the prevention of exacerbations of acne. In the present study 54 patients were involved who after the active therapy used a fixed combination of adapalene 0.1% / BPO 2.5% as maintenance treatment. Only 1 patient (2.9%) with moderate acne and 2 patients (5.8%) with severe acne had a relapse within 6 months of maintenance therapy. The absence of adverse events during the course of treatment was recorded, as well as high adherence of patients to the treatment. During the period of post-treatment observation (6 months after maintenance therapy), among the patients without exacerbations during maintenance therapy, a relapse occurred in 2 (7.1%) patients of group 1 (n = 28) and 2 (8.7%) patients of group 2 (n = 23). The obtained data indicates that maintenance therapy with Effezel® gel can extend the achieved effectiveness of the treatment and prevent the development of relapses.

scholarly journals Fixed combination of adapalene 0.1 % and benzoyl peroxide 2.5 % in therapy of moderate and severe acne

2019 ◽  
Vol 2 (26) ◽  
pp. 79-84
Author(s):  
L. S. Kruglova ◽  
N. V. Gryazeva ◽  
A. R. Nazarenko
Keyword(s):  
Benzoyl Peroxide ◽  
Fixed Combination ◽  
Topical Therapy ◽  
Supportive Therapy ◽  
Medical Practitioner ◽  
Fixed Dose ◽  
Severe Acne ◽  
Acne Scars ◽  
Wide Range ◽  
Dermatological Side Effects

Acne therapy, despite the wide range of therapeutic possibilities, continues to be quite a challenge for the medical practitioner. Nowadays in the current clinical recommendations the preference is given to the fixed doses combinations, in particular to Effezel® (also known as Epiduo®) — adapalene 0.1 % and benzoyl peroxide 2.5 %.Materials and methods. Under our supervision, there were 64 patients with acne. The 1st group — the patients with severe papulo-pustular acne: they received therapy with the mentioned above fixed combination for 6 months, in some cases (33.3 % of patients) doxycycline at a dose of 100 mg/day was prescribed for the first 4 weeks, then — adapalene 0.1 % and benzoyl peroxide 2.5 % as a maintenance therapy every or every other day for 6 months. The 2d group — the patients with moderate-severe papulo-pustular acne having formed atrophic post-acne scars: they received the mentioned above fixed combination therapy for 6 months and RF-micro-needle therapy (3 procedures with a 4 weeks interval between them). The 3d group — the patients with nodular and cystic acne: after a treatment course with a systemic retinoid the patients received the fixed dose combination of adapalene 0,1 % and benzoyl peroxide 2,5 % once a day for 6 months. Patients of all groups used dermatocosmetics Cetaphil PRO* (acne prone skin).Results and discussion. In the 1st group, the score IGA = 0 (Investigator Global Assessment with the scores from 0 — clear skin to 4 — severe acne) was found in 85.7 % of the patients, in the 2d group — in 77.3 % and in the 3d group — in 81.0 %. According to sebumetria data a significantly positive dynamic was observed in the 1st and the 2d groups after a month of therapy (p < 0.05). After 3 months of the therapy a positive dynamics was fixed as more than 50 % in the 1st and the 2d groups. In the 3d group a negative dynamic regarding to sebumetria measurements was not observed during the whole supportive therapy course. Skin hydration was initially reduced in all patients with the meaningful results fixed in the patients of the 3d group (p < 0.05). In the 1st month of the therapy the skin moisturizing’s measurements were slightly decreased in the 1st and 2d groups. The restoration of skin moisturizing was revealed starting from the 2d month of the therapy and by the end of the treatment course, it was considered as normal or increased. In the 3d group during the transition to the topical therapy the skin moisturizing wasn’t decreased and had a further tendency to be increased.Summary. The fixed doses combination of adapalene 0.1 % and benzoyl peroxide 2.5 % has demonstrated a clinically proven effectiveness against moderate-severe acne with atrophic post-acne scars, as well as in the treatment of severe papulo-pustular acne both as monotherapy and in combination with oral doxycycline 100 mg/day in the first 4 weeks of the treatment course. The use of a fixed doses combination of adapalene 0.1 % and benzoyl peroxide 2.5 % after a course of a systemic retinoid ensures the maintenance and even improvement of the achieved effect. Specialized cosmetics Cetaphil® PRO (acne prone skin) helps to prevent and reduce the severity of some predictable dermatological side effects of retinoids.

scholarly journals Comparison of Latanoprost/Timolol with Carbonic Anhydrase Inhibitor and Dorzolamide/Timolol with Prostaglandin Analog in the Treatment of Glaucoma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Kenji Inoue ◽  
Shoichi Soeda ◽  
Goji Tomita
Keyword(s):  
Visual Field ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Field Testing ◽  
Mean Deviation ◽  
Single Action ◽  
Before And After ◽  
Group 2 ◽  
Concomitant Medications ◽  
Medication Changes

Purpose.We retrospectively reviewed medical records of glaucoma patients to investigate how switching medications may affect intraocular pressure (IOP) management. Three concomitant medications were changed to two medications: one combination drop and one single-action drop. Associated adverse effects were also examined.Subjects and Methods.A total of 112 patients with primary open-angle glaucoma or ocular hypertension were examined. All patients were concomitantly using a prostaglandin (PG) analog, aβ-blocker, and a carbonic anhydrate inhibitor (CAI). Fifty-five patients began using latanoprost (PG analog)/timolol (β-blocker) fixed-combination (LTFC) drops and a CAI (group 1), and 57 patients began using dorzolamide (CAI)/timolol fixed-combination (DTFC) drops and a PG analog (group 2). The IOP was measured every 6 months for 2 years following medication changes. Changes in visual field mean deviation (MD) and medication discontinuations were also examined.Results.There were no significant differences in IOP or MD values before and after medication changes in either group. The proportion of medication discontinuations, uncontrolled IOP, and adverse reactions was similar in both groups.Conclusion.Switching patients from multiple single-action medications to combination medications was not associated with changes in IOP, visual field testing results, or adverse event frequency.

scholarly journals Efficacy of a New Non-drug Acne Therapy: Aloe Vera Gel Combined With Ultrasound and Soft Mask for the Treatment of Mild to Severe Facial Acne

2021 ◽  
Vol 8 ◽  
Author(s):  
Hongyu Zhong ◽  
Xiang Li ◽  
Wanqi Zhang ◽  
Xiaoxiao Shen ◽  
Yuangang Lu ◽  
...  
Keyword(s):  
Treatment Group ◽  
Side Effects ◽  
Combined Therapy ◽  
Aloe Vera ◽  
Physical Method ◽  
Control Group ◽  
Severe Acne ◽  
Aloe Vera Gel ◽  
Before And After ◽  
Acne Therapy

Background: Acne is a chronic disorder that affects almost 80% of adolescents and young adults, causing psychological and emotional distress. However, the current treatments for acne are either ineffective or have many side effects. This study was designed to confirm and objectively quantify the effect of a new non-drug combined therapy on acne.Methods: This study innovatively utilized ultrasound, which enhanced the absorption of aloe vera gel, and soft mask to make a purely physical method without any drugs. In both the treatment group and control group, the number of papules/pustules and the area of hyperpigmented lesions were counted, and a smart mirror intelligent face system was used before and after the combined therapy. Alterations in the skin functional index were recorded and analyzed statistically.Results: In the treatment group, the combined therapy significantly reduced the number of papules and the area of hyperpigmented lesions and improved skin roughness and local blood circulation. In the control group, there was no obvious improvement over 2 months.Conclusion: This study suggests that the new non-drug combined therapy significantly improved acne, which provided experimental evidence and treatment guidance for patients with mild to severe acne, especially patients with moderate acne. This new therapy may possibly be an appropriate method for patients who seek topical treatments with mild side effects and low antibiotic resistance rates.

scholarly journals A Comparative Analysis of the Efficacy and Safety of fixed Combinations of Latanoprost/Timolol vs Dorzolamide/Timolol in Primary Open Angle Glaucoma or Ocular Hypertension

2012 ◽  
Vol 46 (4) ◽  
pp. 172-176
Author(s):  
Sukhsagar Ratol ◽  
Rani Walia ◽  
Mridu Chaudhry
Keyword(s):  
Ocular Hypertension ◽  
Primary Open Angle Glaucoma ◽  
Fixed Combination ◽  
Open Angle Glaucoma ◽  
Eye Drops ◽  
Open Angle ◽  
Once Daily ◽  
Group 2 ◽  
Diurnal Iop ◽  
Group 1

ABSTRACT Background Glaucoma is a leading cause of irreversible blindness. The fundamental problem in medical management of glaucoma is of patient compliance. An ideal drug or a drug combination is needed to slow the progression of this majorly symptomless disease. Aim To compare the efficacy and tolerability of the fixed combination latanoprost and timolol instilled once daily in the evening vs fixed combination of dorzolamide and timolol instilled twice daily in primary open angle glaucoma or ocular hypertension. Materials and methods A 12-week, randomized, open, parallel group study including 50 patients with primary open angle glaucoma or ocular hypertension was conducted at a tertiary care hospital. Patients were randomized to group 1, (fixed combination (FC) latanoprost and timolol eye drops, once daily in evening) and group 2, (FC dorzolamide and timolol eye drops, twice daily). At baseline, 2, 4 and 12 weeks, IOP was recorded at 9 AM and 12 noon. The difference in IOP reduction in two treatment groups from baseline to 12 weeks was the main outcome measure. Results Mean diurnal IOP was similar at baseline for both groups. Mean reduction in IOP from baseline to 12 weeks was 9.92 mm Hg (p = 0.001) in group 1 and 9.22 (p = 0.001) in group 2. The reduction in IOP in both groups 1 and 2 was statistically significant at all time intervals. There was a statistically significant advantage for group 1 at 12 weeks for both time readings (p = 0.013 and 0.002 respectively) as compared to group 2. Conclusion The fixed combination of latanoprost and timolol was more effective than that of dorzolamide and timolol in reducing mean diurnal IOP and both treatments were well tolerated. To confirm further such studies are required. How to cite this article Ratol S, Walia R, Chaudhry M. A Comparative Analysis of the Efficacy and Safety of fixed Combinations of Latanoprost/Timolol vs Dorzolamide/Timolol in Primary Open Angle Glaucoma or Ocular Hypertension. J Postgrad Med Edu Res 2012;46(4):172-176.

scholarly journals Prevention of Transcutaneous Sensitization to Cow Milk Proteins in Infants with Atopic Dermatitis: Cohort Study

2020 ◽  
Vol 19 (6) ◽  
pp. 538-544
Author(s):  
Nikolay N. Murashkin ◽  
Svetlana G. Makarova ◽  
Stepan G. Grigorev ◽  
Dmitri V. Fedorov ◽  
Roman A. Ivanov ◽  
...  
Keyword(s):  
Atopic Dermatitis ◽  
Maintenance Therapy ◽  
Milk Proteins ◽  
Allergic Diseases ◽  
Specific Ige ◽  
Dispersion Analysis ◽  
Cow Milk ◽  
Group 2 ◽  
Group 1

Background. Malformations in epidermal barrier in children with atopic dermatitis (AD) can cause transcutaneous sensitization with further development of allergic diseases that can worsen the AD course and significantly reduces patients’ quality of life.Objective. The aim of the study was to determine the effect of topical treatment and maintenance therapy with pimecrolimus 1% cream (PIM) and topical glucocorticosteroids (tGCS) in infants with AD on reducing the risk of developing transcutaneous sensitization (due to the levels of specific IgE to the cow milk protein over time) and on reducing the disease severity (by the EASI scale).Methods. The study included children aged from 1 to 4 months with early manifestations of moderate and severe AD. The severity of AD was estimated via the EASI scale at start of observation, then at 6, 9 and 12 months of life. The class and level of specific IgE to cow milk proteins (CMP) were determined by the ImmunoCAP method at the point of enrolment and at the ages of 6 and 12 months. Statistical analysis of studied indicators dynamics and their comparison in research groups was carried out using multifactorial dispersion analysis.Results. The study included 36 patients. All patients have received standard tGCS therapy in combination with emollients (wet wrap) for 10 days. The maintenance therapy was prescribed in postacute period. It included topical calcineurin inhibitor PIM 2 times/day for 3 months, then double application (morning/evening) 3 times/week up to the age of 1 year old (group 1). Other group had maintenance therapy — tGCS2 times/week for 3 months, and then at AD aggravation (group 2). Group 1 has shown lower level of sensitization to CMP at the age of 6 and 12 months and more significant decrease in AD severity according to EASI scale compared to group 2.Conclusion. The treatment with PIM is effective in therapy of AD and prevention of transcutaneous sensitization in infants.

scholarly journals Acne as a common extraintestinal manifestation of celiac disease. Treatment approaches

2021 ◽  
pp. 126-135
Author(s):  
S. S. Ledentsova ◽  
N. I. Gulyaev ◽  
S. I. Sitkin ◽  
P. V. Seliverstov
Keyword(s):  
Celiac Disease ◽  
Intestinal Microflora ◽  
Disease Incidence ◽  
Topical Therapy ◽  
Risk Groups ◽  
Skin Condition ◽  
Plantago Ovata ◽  
Extraintestinal Manifestation ◽  
Severe Acne ◽  
Group 2

Introduction. At present, global prevalence of celiac disease attracts increasingly greater attention of researchers. The study of its extraintestinal manifestations is a crucial task for early and timely diagnosis of the disease, as well as the identification of new risk groups. To date, there are only isolated publications concerning the study of celiac disease incidence in patients with acne. This topic is of particular interest since systemic retinoids with a hepatotoxic effect and antibiotics significantly affecting the intestinal microflora are the first-line drugs in the treatment of moderate and severe acne. Undoubtedly, these side effects influence on the course of acne in celiac patients. So, to prevent the complications of the treatment, it is necessary to search, develop and introduce into practice safe combinations, including drugs having a protective effect both for the intestinal microflora and for the liver. It is known that psyllium (Plantago ovata seed shells/Ispaghula husks) have similar effects.Objective. To study the effect of psyllium on the tolerability and effectiveness of systemic therapy with isotretinoin and doxycycline in patients with moderate acne with celiac disease. Material and methods. We examined 65 patients with celiac disease suffering from moderate acne, who were randomized into two groups – group 1 (taking an antibiotic – doxycycline) and group 2 (taking a systemic retinoid – isotretinoin), then each group was divided into two subgroups A and B, depending on the prebiotic intake (powder of oval plantain seeds shells Plantago ovata Forssk (psyllium). The patients were followed up for 8 and 24 weeks, respectively. All patients received adjuvant topical therapy. In each group, a medical check-up was done before treatment, 2 months after the onset and then after the treatment completion.Conclusion. Patients in both subgroups who received psyllium in addition to antibiotics and systemic retinoids treatment showed better results after treatment in terms of skin condition, overall health and quality of life. 

Molecule which changed the view on skin treatment

2021 ◽  
pp. 44-55
Author(s):  
L.Ya. Fedorich
Keyword(s):  
Retinoic Acid ◽  
Nuclear Receptors ◽  
Mechanism Of Action ◽  
Molecular Mechanisms ◽  
Local Treatment ◽  
Mechanisms Of Action ◽  
Clinical Effects ◽  
Topical Retinoids ◽  
Acne Therapy ◽  
Universal Mechanism

Objective — to study the modern classification, mechanisms of action and clinical effects of vitamin A derivatives, to analyze retinoid for local treatment of various dermatoses with a universal mechanism of action at the epidermis and dermis levels. Materials and methods. A review of the literature and an analysis of the results of international clinical trials of drugs based on the natural retinoid of the first generation — tretinoin (retinoic acid) is presented. The works of dozens of authors since 1980s to the present day are analyzed. Most sources provide detailed information on the results of topical retinoids in acne therapy, which are the base of clinical guidelines. Long-term (6 months or more) studies of retinoic acid-based preparations carried out in recent decades have discovered the unique clinical effects of tretinoin in the treatment of skin photoaging, actinic keratosis, etc. They are achieved due to the effect of tretinoid on the nuclear receptors of keratinocytes and fibroblasts. Results and discussion. The molecular mechanisms of action of retinoic acid, realizing the cellular and tissue effects of the most studied retinoid, are systematized and grouped in a single review. It has been proven that a unique feature of tretinin is its ability to activate directly all subtypes of RARs- and, indirectly, RARs-nuclear receptors of skin cells. A new modern drug for external use is presented — AltrenoТМ lotion containing micronized 0.05 % tretinoin in combination with sodium hyaluronate, soluble collagen and glycerin. This combination exhibits the expected clinical efficacy in acne therapy and prevents side effects such as dryness, redness and exfoliation. AltrenoТМ is approved for use in children of 9 years of age and older. Conclusions. Tretinoin (retinoic acid) is a modern powerful retinoid with a universal mechanism of action, recommended for the treatment of acne.

Individualised Homeopathic Treatment of Acne—An Analysis of 83 Patients

Homeopathy ◽  
2021 ◽  
Author(s):  
Lawrence Chukwudi Nwabudike
Keyword(s):  
Inflammatory Lesions ◽  
Severe Acne ◽  
Homeopathic Medicine ◽  
Results Of Treatment ◽  
Therapeutic Guidelines ◽  
Acne Therapy ◽  
The Face ◽  
Pre Treatment ◽  
Lost To Follow Up

Abstract Background Acne is a common disorder of the pilosebaceous follicle. The face, back and chest are usually involved. It leads to significant diminution in quality of life. Numerous treatments are documented in therapeutic guidelines. Naturopathic approaches have been proposed in some, but the role of homeopathy is not examined. Methods In this study, 83 patients treated for acne with individualised homeopathic medicine alone were reviewed. Most had received conventional acne treatment, with limited success prior to presentation for homeopathy. Each patient was prescribed a single homeopathic medicine and followed up at 6- to 8-week intervals. The individualisation process resulted in 17 different medicines being used in this group. Photographic documentation was obtained per patient, with informed consent. Patients were classified as mild (comedonal acne with no papules or pustules), moderate (inflammatory and non-inflammatory lesions) and severe (predominantly inflammatory lesions: pustules, cysts, nodules). Results of treatment were recorded as remission (decrease in new lesion number, duration and intensity), failure to respond, and lost to follow-up (LTF). Results The average age of patients was 21.5 years (range 11–45 years). The F:M ratio was 55 (66.3%):28 (33.7%). Average pre-treatment duration was 5.5 years (0.25–22 years). Seven (8.4%) patients had mild acne, 37 (44.6%) moderate, and 39 (47%) severe acne. There were 13 (15.7%) LTFs, two (2.4%) failed to respond, and 68 (81.9%) went into remission. Average time to remission was 1.9 months (range 1.5–6 months), with no relapses or side-effects. The most commonly prescribed medicines were Lycopodium (38.6%), Palladium (15.7%) and Platinum (12.1%). Conclusion Individualised homeopathy may be useful for acne therapy. The most useful medicines appeared to be Lycopodium, Palladium and Platinum, though 17 different medicines were used in this study, underscoring the value of individualisation of therapy, a key characteristic of homeopathy.

Minocycline Topical Foam: A New Drug for the Treatment of Acne

2020 ◽  
Vol 55 (1) ◽  
pp. 105-110
Author(s):  
Erin St. Onge ◽  
W. Cary Mobley
Keyword(s):  
Bacterial Resistance ◽  
Data Extraction ◽  
Acne Vulgaris ◽  
Phase 1 ◽  
Systemic Exposure ◽  
Preclinical Study ◽  
Severe Acne ◽  
Assessment Scores ◽  
Acne Lesion ◽  
Acne Therapy

Objective: To review the safety and efficacy of minocycline 4% topical foam for the treatment of moderate to severe acne vulgaris in adults and pediatric patients aged 9 years and older. Data Sources: A literature search through PubMed and EMBASE was conducted using the following keywords: FMX101, minocycline, foam, and acne. Study Selection and Data Extraction: Articles selected included those describing preclinical and clinical studies of pharmacokinetics, efficacy, or safety of topical minocycline foam. Data Synthesis: Minocycline 4% topical foam was shown in a preclinical study to effectively deliver minocycline to the pilosebaceous unit, with little penetration beyond the stratum corneum. This was consistent with a phase 1 pharmacokinetic study of the foam, which yielded a significantly reduced systemic exposure of minocycline compared with oral minocycline. In phase 2 and phase 3 clinical trials, the foam significantly reduced acne lesion counts and Investigator’s Global Assessment scores of acne severity compared with placebo. The foam has a good safety profile, with headache, mild erythema, hyperpigmentation, and mild dryness among the most common adverse effects. Relevance to Patient Care and Clinical Practice: Topical antibiotics have been a mainstay of acne therapy with the benefit of less systemic exposure compared with oral antibiotics. However, the development of bacterial resistance has reduced their use, thereby reducing options for many patients with acne. Minocycline 4% topical foam is a safe and effective alternative, which may help restore this important therapeutic approach for treating acne vulgaris.

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