Advantages of Tailored Isotretinoin Treatment in Moderate to Severe Acne: Real-Life Data

Skroza, Nevena; Tolino, Ersilia; Balduzzi, Veronica; Bernardini, Nicoletta; Mambrin, Alessandra; Marchesiello, Anna; Marraffa, Federica; Rossi, Giovanni; Volpe, Salvatore; Proietti, Ilaria; Potenza, Concetta

doi:10.3389/fphar.2021.733526

Cited by 8 publications

(10 citation statements)

References 17 publications

(17 reference statements)

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“…16,22,23 Therefore, recent studies have concluded that individual conditions should be considered when designing treatment protocols for moderate acne. 16,24 However, the current prescription still fails to take into account different gradations of the severity of moderate acne. Our study identifies acne grading scores as an important factor in designing a treatment protocol for moderate acne which could be useful for clinicians to individualize treatment dose based on patient's conditions.…”

Section: Results For Side-effects and Patient Satisfactionmentioning

confidence: 99%

“…However, treatment outcomes have varied widely from one study to another even when using the same therapy regimen 16,22,23 . Therefore, recent studies have concluded that individual conditions should be considered when designing treatment protocols for moderate acne 16,24 . However, the current prescription still fails to take into account different gradations of the severity of moderate acne.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: Randomized, controlled, comparative study

Kassem

Ismail

Hassan

2022

Dermatologic Therapy

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Protocols for treating acne with isotretinoin have varied widely because some factors associated with relapse and treatment duration have not yet been fully determined. This paper evaluates the effectiveness of conventional, low, and intermittent isotretinoin dosage protocols in the treatment of moderate acne and investigates the relationships between GAGS score, treatment duration and relapse rate. The 107 patients with moderate acne were randomly divided into three groups who received isotretinoin for 24 weeks (Group A: 0.5–1 mg/kg/day; Group B: 0.25–0.4 mg/kg/day; Group C: 0.5–0.7 mg/kg/day for 1 week out of every 4 weeks). The results show that both conventional and continuous low doses achieved full clinical effectiveness with minimum relapse rates. However, fewer side effects and better patient satisfaction were reported with the low dose. Significant differences in GAGS scores after 24 weeks were found between groups B and C (p = 0.037) and between groups A and C (p < 0.001), while no significant differences were found between groups A and B (p = 0.153). It was observed that relapse rate increased with initial GAGS score. The average relapse rate was 58.0% for those with initial GAGS scores of 25–30 compared with 5.5% for those with scores of 19–24. It was also noticed that, among the patients who relapsed, the highest percentage (56.3%) were in the age group <20 years. However, GAGS (β = 0.646, t = 8.323, p < 0.001) was found to be a better predictor of relapse than age (β = 0.083, t = 1.073, p = 0.286). These results suggest that initial GAGS score is an important factor in determining the treatment protocol for moderate acne. Furthermore, this study recommends that a low‐dose treatment is most suitable when GAGS <25, as it can achieve complete clearance of acne with minimal relapses and side effects.

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Section: Results For Side-effects and Patient Satisfactionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: Randomized, controlled, comparative study

Kassem

Ismail

Hassan

2022

Dermatologic Therapy

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“…The high cumulative dose is adversely associated with an increased risk of OI side effects and poor medication adherence. 32 Moreover, neither daily dosage nor cumulative dose influenced acne relapse as long as treatment continued for ≥2 months after the acne had completely resolved. 33 These contradictory findings support the concept of extending OI (at least 1 month) after complete clearance of acne.…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Acne Vulgaris Relapse in Sudanese Patients Treated with Oral Isotretinoin: Rate and Predictive Factors

Ibrahim¹,

Osman²,

Awaad³

et al. 2023

JMDH

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Purpose Acne vulgaris is a skin disorder primarily affecting teenagers and young adults. Acne relapse is the main drawback of oral isotretinoin (OI), which is the golden therapy for severe acne. This study aimed to assess the rate and predictive factors of acne relapse among Sudanese patients using OI. Patients and Methods A cross-sectional study was conducted in a dermatology and venereology clinic-Sudan, using a self-administered questionnaire and data collection sheet. Patients using OI for acne treatment were enrolled in the study. Chi-square test and logistic regression analysis were used to evaluate the association between variables. P-value <0.05 was considered statistically significant. Results 225 acne patients (mean age: 26.0±4.2 years, females: 88.9%) were included in this study. OI daily dose ranged from 0.25 to 1 mg/kg/day, with frequent daily doses of 40–49 mg (57.3%) over 3–6 months (81.8%). Around one-third of patients (36%) received maintenance therapy after completion of OI course. At a 2-year follow-up, approximately 36% of patients experienced acne relapse that commonly occurred within 6–18 months after the last OI therapy. Early discontinuation of OI was a positive predictor of acne relapse which was 3.99 times greater in patients who had early discontinued OI than those completing the planned OI course (OR=3.99; p =0.002). OI cumulative doses of 120–139 mg/kg and 140–159 mg/kg were negative predictors of acne relapse (OR=0.23; p =0.001 and OR=0.15; p =0.02, respectively). Most patients (94.2%) received prescription OI, and 76.4% of women were advised to use contraceptives. About 69% of patients practiced skin care. Conclusion About one-third of patients experienced acne relapse. Early discontinuation and low cumulative doses of OI are the main risk factors for acne relapse. Long-term therapy of OI, with cumulative doses of 120–159 mg/kg, would be beneficial to reduce acne relapse.

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“…В большинстве случаев встречается персистирующее акне, которое наблюдается у 73,2-82% женщин со взрослым акне [11,[14][15][16][17][18]. Акне с поздним началом встречается гораздо реже -у 20-40% женщин [8,19,20].…”

Section: типы течения акнеunclassified

Adult female acne: relevance and possible solutions

et al. 2023

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In recent years, there has been an increase in the proportion of AFA in the structure of acne incidence. The etiopathogenesis of the disease is multicomponent and has not been fully elucidated. It is assumed that hormonal factors and chronic activation of innate immunity are involved in the process against the background of genetic predisposition, which are stimulated by external environmental factors: daily stress, Western-style diet, tobacco use, hormonal drugs, cosmetics. The article presents a modern classification of the clinical course of AFA and scales for assessing the severity of the course of the disease: GEA (Global Acne Severity Scale) and AFAST (Adult Female Acne Scoring Tool). AFA is predominantly characterized by a mild or moderate course. Treatment requires a personalized approach with particular attention to the individual needs and characteristics of adult women. When choosing a topical therapy, the doctor should consider the less pronounced oiliness of the skin, the slow progression of the disease with the outcome in hyperpigmentation and scarring. Modern acne treatment regimens include systemic and topical therapy along with proper basic skin care. The most effective topical agents include retinoids, which can induce a specific biological response by binding and activating retinoic acid receptors. Comedonal and mild papulopustular acne are indications for adapalene monotherapy for acne in adult women. Adaklin (0.1% adapalene) cream is a highly effective first choice for the pathogenetic treatment of AFA. Rational mono- and combination therapy with adapalene is the key to successful external therapy of mild and moderate AFA and prevention of post-acne. The review provided up-to-date, evidence-based information on the clinical presentation, etiopathogenesis, and treatment of adult female acne (AFA).

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Advantages of Tailored Isotretinoin Treatment in Moderate to Severe Acne: Real-Life Data

Cited by 8 publications

References 17 publications

Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: Randomized, controlled, comparative study

Evaluation of the efficacy and relapse rates of treatment protocols for moderate acne using isotretinoin based on the global acne grading system: Randomized, controlled, comparative study

Acne Vulgaris Relapse in Sudanese Patients Treated with Oral Isotretinoin: Rate and Predictive Factors

Adult female acne: relevance and possible solutions

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