Real-world adherence to topical therapies in patients with moderate acne

Xuân-Lan Lam Hoai; Viviane De Maertelaer; Thierry Simonart

doi:10.1016/j.jdin.2020.12.006

Real-world adherence to topical therapies in patients with moderate acne

JAAD Int. 2021 Jan 13:2:109-115. doi: 10.1016/j.jdin.2020.12.006. eCollection 2021 Mar.

Authors

Xuân-Lan Lam Hoai¹, Viviane De Maertelaer², Thierry Simonart³

Affiliations

¹ Department of Dermatology, St Pierre - Brugmann - Hôpital Universitaire Des Enfants Reine Fabiola (HUDERF) University Hospitals, Université Libre de Bruxelles, Belgium.
² Department of Biostatistics, Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM), Université Libre de Bruxelles, Brussels, Belgium.
³ Department of Dermatology, Delta Hospital, Centre Hospitalier Interrégional Edith Cavell (CHIREC), Université Libre de Bruxelles, Brussels, Belgium.

Abstract

Background: Real-life data on topical treatments in daily practice in patients with moderate acne are poorly characterized.

Objective: To investigate the drug survival of topical treatments administered to patients with moderate acne in a daily practice.

Methods: Survival analysis was performed on subjects (Belgian university hospital and private practice outpatient dermatology patients) with moderate acne who received topical therapies according to the current published guidelines.

Results: A total of 1160 treatment series (1029 patients) were included, including benzoyl peroxide (BPO, n = 93), azelaic acid (n = 246), adapalene (n = 254), a fixed combination of adapalene 0.1% and BPO 2.5% (A/BPO, n = 264), and a fixed combination of clindamycin 1.2% and tretinoin 0.025% gel (Clin-RA, n = 303). The calculated overall median treatment duration of all drugs was 2 months. The probability of treatment discontinuation after only 3 months was 50%. Overall, the drugs were discontinued for the following reasons: controlled acne (9%), side effects (9%), ineffectiveness (52%), combination of side effects and ineffectiveness (3%), and other reasons (1%). Overall, 27% patients were lost to follow-up.

Limitations: The post hoc study design and generalizability limit interpretation of the data.

Conclusion: Overall, the median treatment duration of topical anti-acne therapies was short (2 months). The main reason for discontinuation was ineffectiveness.

Keywords: A/BPO, fixed combination of adapalene 0.1% and BPO 2.5%; BPO, benzoyl peroxide; Clin-RA, fixed combination of clindamycin 1.2% and tretinoin 0.025% gel; LTFU, lost to follow-up; RCT, randomized controlled triaL; acne; adapalen; benzoyl peroxide; clindamycin; drug survival; topical.