Treatment failure of patients using topical acne treatments: an observational retrospective cohort study

Abstract

Background: While limited data from clinical trials show differences in efficacy between topical acne combination products and monotherapies, the impact in clinical practice is not explored. Purpose: To evaluate the effectiveness in clinical practice of prescribing topical acne combination treatments compared to monotherapy product(s) in minimizing treatment failures. Methods: Patients diagnosed with acne (ICD-9: 706.1) by a dermatologist between January 2009 and September 2011 and initially prescribed a topical acne treatment were identified. Multivariate Cox proportional hazards models were employed to compare the hazards of treatment failure for patients initially prescribed a combination product versus one monotherapy or multiple monotherapies. Subgroup analyses were also performed. Results: Three hundred and thirty-five patients were initially prescribed topical product(s) exclusively. The hazards of treatment failure for those prescribed a combination product compared to those prescribed one monotherapy product was HR = 0.91 (p = 0.65) and compared to those prescribed multiple monotherapy products was HR = 0.73 (p = 0.17). Limitations: Disease severity and treatments prescribed outside of the hospital system were not available. Conclusions: Treatment failures were consistent for patients prescribed combination product(s) or monotherapies.