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New topical combinations in acne therapy

https://doi.org/10.21518/ms2024-362

Abstract

Introduction. Therapeutic treatment modalities for acne involve both topical and oral medications. Fixed-dose combinations that affect all components of the pathogenesis of acne vulgaris are given preference among topical medications.

Aim. To evaluate the efficacy and tolerability of Metrogyl® a topical drug, containing adapalene and metronidazole, which is used as topical therapy in patients with mild to moderate acne.

Materials and methods. A prospective, open-label, randomized, single-centre comparative study was conducted in 2022. A total of 60 patients were subjected to the Mir-O-Med clinic-based observation (Krasnodar): 19 men and 41 women aged 18 to 45 years with mild to moderate acne. Group 1 received a fixed-dose combination of adapalene 1.0 mg and metronidazole

10.0 mg (Metrogyl® A); Group 2 – a fixed-dose combination of adapalene 0.1% and clindomycin phosphate 1%; Group 3 – a fixed-dose combination of adapalene 0.1% and benzoyl peroxide 2.5% gel; Group 4 – adapalene 0.1%. Group 5, a separately created group, included patients from Group 1, who continued therapy for another 3 months.

Results. After therapy, 6 (40%) patients from Group 1 archived clinical remission, and 9 (60%) patients found significant improvement. No deterioration in patients’ condition or absence of clinical effects was observed during therapy. The combination of adapalene and metronidazole (Metrogyl® A) to treat mild to moderate acne is comparable in terms of efficacy to the combination of adapalene and benzoyl peroxide, 10% more efficient than topical adapalene therapy and 30% more efficient than topical antibiotics combination.

Conclusion. The obtained results showed high therapeutic efficacy, good tolerability and safety of Metrogyl® A, which allows to use it as monotherapy and as part of combination with other agents in patients with mild to moderate acne.

About the Author

О. A. Katkhanova
Klinika Mir-O-Med; Klinika Ekaterininskaya
Russian Federation

Olga A. Katkhanova, Dr. Sci. (Med.), Dermatovenerologist, Cosmetologist, Klinika Mir-O-Med; Dermatovenerologist, Cosmetologist, Klinika Ekaterininskaya

132, Rashpilevskaya St., Krasnodar, 350000,

37/1, Kubanskaya Naberezhnaya St., Krasnodar, 350063



References

1. Eichenfield DZ, Sprague J, Eichenfield LF. Management of Acne Vulgaris: A Review. JAMA. 2021;326(20):2055–2067. https://doi.org/10.1001/jama.2021.17633.

2. Reynolds RV, Yeung H, Cheng CE, Cook-Bolden F, Desai SR, Druby KM et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2024;90(5):P1006.e1–1006.e30. https://doi.org/10.1016/j.jaad.2023.12.017.

3. Gollnick H, Abanmi AA, Al-Enezi M, Al Hammadi A, Galadari I, Kibbi AG, Zimmo S. Managing acne in the Middle East: consensus recommendations. J Eur Acad Dermatol Venereol. 2017;31(7 Suppl.):4–35. https://doi.org/10.1111/jdv.14491.

4. Hazarika N. Acne vulgaris: new evidence in pathogenesis and future modalities of treatment. J Dermatolog Treat. 2021;32(3):277–285. https://doi.org/10.1080/09546634.2019.1654075.

5. Nazarenko AR, Potekaev NN, Lvov AN, Klyachko NL, Majouga AG. Role of matrix metalloproteinases in acne inflammation: pathogenesis, diagnosis, treatment, prognosis. Medical Alphabet. 2021;(9):24–28. (In Russ.) https://doi.org/10.33667/2078-5631-2021-9-24-28.

6. Lichtenberger R, Simpson MA, Smith C, Barker J, Navarini AA. Genetic architecture of acne vulgaris. J Eur Acad Dermatol Venereol. 2017;31(12):1978–1990. https://doi.org/10.1111/jdv.14385.

7. Rumyantsev AG, Demina OM, Raikina EV. Pathogenetic mechanism of acne-coupled inflammation. Russian Journal of Immunology. 2020;23(1):19–26. (In Russ.) https://doi.org/10.46235/1028-7221-002-PMO.

8. Selway JL, Kurczab T, Kealey T, Langlands K. Toll-like receptor 2 activation and comedogenesis: implications for the pathogenesis of acne. BMC Dermatol. 2013;13:10. https://doi.org/10.1186/1471-5945-13-10.

9. Li ZJ, Choi DK, Sohn KC, Seo MS, Lee HE, Lee Y et al. Propionibacterium acnes activates the NLRP3 inflammasome in human sebocytes. J Invest Dermatol. 2014;134(11):2747–2756. https://doi.org/10.1038/jid.2014.221.

10. Dréno B, Pécastaings S, Corvec S, Veraldi S, Khammari A, Roques C. Cutibacterium acnes (Propionibacterium acnes) and acne vulgaris: a brief look at the latest updates. J Eur Acad Dermatol Venereol. 2018;32(2 Suppl.):5–14. https://doi.org/10.1111/jdv.15043.

11. Dréno B, Bettoli V, Araviiskaia E, Sanchez Viera M, Bouloc A. The influence of exposome on acne. J Eur Acad Dermatol Venereol. 2018;32(5):812–819. https://doi.org/10.1111/jdv.14820.

12. Thiboutot DM, Dréno B, Abanmi A, Alexis AF, Araviiskaia E, Barona Cabal MI et al. Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne. J Am Acad Dermatol. 2018;78(2 Suppl. 1):S1–S23.e1. https://doi.org/10.1016/j.jaad.2017.09.078.

13. Lvov AN, Kornyat MS, Igoshina AV, Nazarenko AR. Perspectives in acne therapy: an analytical review. Russian Journal of Clinical Dermatology and Venereology. 2019;18(2):115–128. (In Russ.) https://doi.org/10.17116/klinderma201918021115.

14. Baldwin H, Webster G, Stein Gold L, Callender V, Cook-Bolden FE, Guenin E. 50 Years of Topical Retinoids for Acne: Evolution of Treatment. Am J Clin Dermatol. 2021;22(3):315–327. https://doi.org/10.1007/s40257-021-00594-8.

15. Conforti C, Chello C, Giuffrida R, di Meo N, Zalaudek I, Dianzani C. An overview of treatment options for mild-to-moderate acne based on American Academy of Dermatology, European Academy of Dermatology and Venereology, and Italian Society of Dermatology and Venereology guidelines. Dermatol Ther. 2020;33(4):e13548. https://doi.org/10.1111/dth.13548.

16. Leyden J, Stein-Gold L, Weiss J. Why Topical Retinoids Are Mainstay of Therapy for Acne. Dermatol Ther (Heidelb). 2017;7(3):293–304. https://doi.org/10.1007/s13555-017-0185-2.

17. Kolli SS, Pecone D, Pona A, Cline A, Feldman SR. Topical Retinoids in Acne Vulgaris: A Systematic Review. Am J Clin Dermatol. 2019;20(3):345–365. https://doi.org/10.1007/s40257-019-00423-z.

18. Katkhanova OA, Burtseva GN, Solovyova AV. Possibilities of using topical retinoids and azelaic acid in acne therapy. Vestnik Dermatologii i Venerologii. 2024;100(1):63–72. (In Russ.) https://doi.org/10.25208/vdv11661.

19. Kocherovets VI. Theory and practice of the use of metronidazole topical preparations in dermatology. Antibiotics and Chemotherapy. 2019;64(7-8): 38–43. (In Russ.) Available at: https://www.antibiotics-chemotherapy.ru/jour/article/view/154/.

20. Nishimuta K, Ito Y. Effects of metronidazole and tinidazole ointments on models for inflammatory dermatitis in mice. Arch Dermatol Res. 2003;294(12):544–551. https://doi.org/10.1007/s00403-002-0381-4.

21. Schmadel LK, McEvoy GK. Topical metronidazole: a new therapy for rosacea. Clin Pharm. 1990;9(2):94–101. Available at: https://pubmed.ncbi.nlm.nih.gov/2137747/.

22. Tong D, Peters W, Barnetson RS. Evaluation of 0.75% metronidazole gel in acne – a double-blind study. Clin Exp Dermatol. 1994;19(3):221–223. https://doi.org/10.1111/j.1365-2230.1994.tb01170.x.

23. Bannatyne RM. Metronidazole, its bioactive metabolites and acne. Curr Med Res Opin. 1999;15(4):298–299. https://doi.org/10.1185/03007999909116500.

24. Miyachi Y. Potential antioxidant mechanism of action for metronidazole: implications for rosacea management. Adv Ther. 2001;18(6):237–243. https://doi.org/10.1007/BF02850193.


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For citations:


Katkhanova ОA. New topical combinations in acne therapy. Meditsinskiy sovet = Medical Council. 2024;(14):82-92. (In Russ.) https://doi.org/10.21518/ms2024-362

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ISSN 2079-701X (Print)
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