Systematic review on the rapidity of the onset of action of topical treatments in the therapy of mild-to-moderate acne vulgaris

Abstract

The time until a patient achieves a relevant improvement during the treatment of a skin disease is important for selecting a therapy, but has been largely neglected in reviews and guidelines. The aim of this systematic review was to determine the time until the onset of action (TOA) of topical acne treatments. The primary outcome was the TOA defined as the time until a 25% reduction in the mean number of inflammatory lesions had been achieved. A systematic literature search in Medline and Embase was carried out. Clinical trials that evaluated head-to-head comparisons of treatments in patients suffering from mild-to-moderate papulopustular acne were included. Abstract and full-text screening and data extraction were done independently by two investigators. With respect to inflammatory lesions, different concentrations of benzoyl peroxide (BPO) or adapalene did not seem to influence the TOA. BPO seemed to act more quickly than isotretinoin and tretinoin. Adapalene showed a shorter TOA than isotretinoin. Conflicting results were seen when comparing adapalene with tretinoin, with a tendency for adapalene to be faster. Clindamycin/BPO seemed to act more quickly than adapalene. Inconsistent results were seen for the comparison of clindamycin/BPO and BPO alone with a slight indication of a shorter TOA for clindamycin/BPO. Adapalene/BPO and clindamycin/BPO showed comparable TOA. When interpreting the data, the different study designs and the limited study quality need to be taken into account. Further research is needed to identify treatments that offer an early onset of action and possibly help to optimize patients' adherence. TOA should be considered as an additional outcome in acne trials.

Management of acne: Canadian clinical practice guideline

“…16 Ben zoyl peroxide products have a fast onset of action 22 and are available over the counter; thus, they should be considered for initial treatment.…”

Resistance status of antibiotics in Gram-positive bacteria isolated from acne lesions in İstanbul

“…Topikal antibakteriyeller temel olarak, deri yüzeyindeki ve özellikle folliküllerdeki P. acnes popülasyonunu azaltma amacıyla kullanılırlar [13][14][15] . Nadifloksasine direnç gelişimi ile ilgili çalışma sayısı diğer antibiyotiklere göre çok daha azdır.…”

Topical, Biological and Clinical Challenges in the Management of Patients with Acne Vulgaris

“…In a systematic review on acne treatment, Jacobs et al noted that different concentrations of BPO and adapalene did not seem to influence the time taken for resolution of inflammatory lesions; however, both agents produced earlier responses when compared to retinoids, particularly isotretinoin. 54 In addition, combined clindamycin and BPO produced faster responses in comparison to adapalene alone. 54 It is therefore necessary for clinicians to offer longerterm management plans in order to be sure that the treatments are successful in resolving the acne.…”

“…54 In addition, combined clindamycin and BPO produced faster responses in comparison to adapalene alone. 54 It is therefore necessary for clinicians to offer longerterm management plans in order to be sure that the treatments are successful in resolving the acne.…”