medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-249medsovet-7756Research ArticleЗАБОЛЕВАНИЯ КОЖИDERMAL DISEASESПрименение комбинированного препарата с адапаленом/метронидазолом при акнеThe use of a combination drug with adapalene/metronidazole for acnehttps://orcid.org/0000-0003-4583-0617МатушевскаяЕ. В.MatushevskayaE. V.

Матушевская Елена Владиславовна, д.м.н., профессор, профессор кафедры дерматовенерологии и косметологии Академии постдипломного образования, 

125371, Москва, Волоколамское шоссе, д. 91

Elena V. Matushevskaya, Dr. Sci.  (Med.), Professor, Professor of  the Department of  Dermatovenereology and Cosmetology of  the Academy of Postgraduate Education,

 91, Volokolamskoe Shosse, Moscow, 125371

matushevskaya@mail.ruhttps://orcid.org/0000-0002-4123-4204ВладимироваЕ. В.VladimirovaE. V.

Владимирова Елена Владимировна, к.м.н., доцент, заведующая кафедрой  дерматовенерологии и косметологии Академии постдипломного образования,

125371, Москва, Волоколамское шоссе, д. 91

Elena V. Vladimirova, Cand. Sci. (Med.), Associate Professor, Head of the Department of Dermatovenereology and Cosmetology of the Academy of Postgraduate Education, 

91, Volokolamskoe Shosse, Moscow, 125371

wellena@list.ruhttps://orcid.org/0000-0001-5995-6689МатушевскаяЮ. И.MatushevskayaYu. I.

Матушевская Юлия Игоревна, к.м.н., главный врач,

140013, Московская область, Люберцы, ул. Коммунистическая, д. 15

Yuliya I. Matushevskaya, Cand. Sci. (Med.), Chief Physician, 

15, Kommunisticheskaya St., Lyubertsy, Moscow Region, 140013

yuliya-matushevskaya@yandex.ruФедеральный научно-клинический центр Федерального медико-биологического агентства РоссииРоссияFederal Scientific and Clinical Center of the Federal Medical and Biological Agency of RussiaRussian FederationЛюберецкий кожно-венерологический диспансерРоссияLyubertsy Dermatovenerologic DispensaryRussian Federation2023270920230141722Copyright © Матушевская Е.В., Владимирова Е.В., Матушевская Ю.И., 20232023Матушевская Е.В., Владимирова Е.В., Матушевская Ю.И.Matushevskaya E.V., Vladimirova E.V., Matushevskaya Y.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7756

Последние достижения в области изучения влияния микробиома кожи в развитии акне обусловливают необходимость в разработке новых эффективных методов лечения для длительного применения при стойких или рецидивирующих формах заболевания. В обзоре представлен анализ зарубежных и отечественных исследований по вопросам патогенеза и лечения акне. Приводятся последние данные о роли дисбаланса микробиома кожи в развитии акне. Потеря филотипического разнообразия Cutibacterium acnes действует как триггер активации врожденного иммунитета и хронического воспаление при акне. Выделены основные направления в лечении акне, основанные на международных и российских клинических рекомендациях. В настоящее время новое решение в терапии акне заключается в мультимодальном подходе к воздействию на различные звенья патогенеза акне для повышения терапевтической эффективности, безопасности и повышения приверженности пациента к терапии. Определено место топических комбинированных препаратов с фиксированной дозировкой в терапии легкой и среднетяжелой формы акне. В связи с растущей резистентностью к антибиотикам и их более ограниченному применению отмечена необходимость в разработке новых эффективных методов лечения для длительного применения. Фиксированная комбинация адапалена/метронидазола, согласно проведенным исследованиям, является высокоэффективным методом терапии папуло-пустулезного акне умеренной и средней степени тяжести. При сравнении применения фиксированных комбинаций адапалена/метронидазола и адапалена/клиндамицина в лечении пациентов с акне отмечена сопоставимая эффективность и хорошая переносимость обеих комбинаций. На основании данных зарубежных и отечественных исследований показано, что комбинированный препарат адапалена/метронидазола является эффективным и безопасным средством в терапии акне легкой и средней степени тяжести.

The latest advances in the research of the effect of skin microbiome on the occurrence of acne raised the need for the development of new effective treatments for the long-term use in persistent or recurrent disease. The review presents an analysis of foreign and domestic studies on the issues of pathogenesis and treatment of acne. The latest data on the role of skin microbiome imbalance in the occurrence of acne are presented. The Cutibacterium acnes phylotypes diversity loss acts as a trigger for innate immunity activation and chronic inflammation in acne. We show the main directions in the treatment of  acne based on international and Russian clinical guidelines. Today, a  new solution in  acne therapy lies in a multimodal approach to the impact on various links in the pathogenesis of acne to increase therapeutic efficacy, safety, and patient adherence to therapy. The place of topical fixed-dose combination drugs in the treatment of mild to moderate acne has been determined. Due to the growing resistance to antibiotics and their more limited use, it was observed that there is a need to develop new effective treatments for the long-term use. The studies showed that the fixed combination of adapalene/metronidazole is a highly effective treatment for moderate to moderately severe papulopustular acne. The comparative analysis of the use of fixed-dose combinations of adapalene/metronidazole and adapalene/clindamycin in the treatment of patients with acne revealed the comparable efficacy and good tolerability of both combinations. The findings of foreign and domestic studies have proved that the adapalene/metronidazole combination is an effective and safe drug to treat mild to moderate acne.

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The authors declare that there are no conflicts of interest present.