Adapalene/Benzoyl Peroxide Gel 0.3%/2.5%: Effective Acne Therapy Regardless of Age or Gender

severe acne, which may be an additional important reason for using A/BPO 0.3% early in treatment. A phase II open-label pilot study of adapalene 0.3% and vehicle on the appearance of new scars showed that 24 weeks treatment with adapalene resulted in a 1 - 2 grade improvement of global scar grade in 56% of patients.28 A follow-up split-face study of A/BPO gel 0.3%/2.5% in subjects with moderate acne and facial atrophic scars showed that A/BPO gel 0.3%/2.5% stabilized total scar count at 6 months. In contrast, scars continued to form on the vehicle treated side, and by month 6 the difference in scar count change between A/BPO 0.3%/2.5% and vehicle was statistically significant (P = 0.036).29 At the molecular level, adapalene down-regulates expression of toll-like receptor 2 (TLR2), beta defensing 4, and interleukin 18, and has been shown to increase CD1d expression, reducing overall in ammation.^30-32 In scarring, adapalene treatment was associated with enhanced collagen synthesis (collagen-3 and procollagen-1).²⁸ We have previously reported that the efficacy and safety of A/ BPO 0.1%/2.5% in adult females was comparable to that observed in adolescent females.³³ This analysis shows that the higher concentration A/BPO 0.3% is a good option for patients with moderate to severe acne (with a greater number of baseline inflammatory and noninflammatory lesions than is generally seen in acne trials) of both genders and across the age spectrum. A/BPO gel 0.3%/2.5% was safe and well tolerated in all population sub-groups, with tolerability that was comparable to vehicle at week 12. Although the original study was not designed to compare A/BPO gel 0.3%/2.5% vs A/BPO gel 0.1%/2.5%, a treatment arm with A/BPO 0.1%/2.5% was included to provide a tolerability benchmark. As Stein Gold et al reported, the local tolerability profile of A/BPO gel 0.3%/2.5% in this study was similar to that of A/BPO gel 0.1%/2.5%.¹⁶ With both concentrations, scores for tolerability signs/symptoms such as erythema, dryness, and stinging/burning were worst in the rst week but were primarily mild to moderate in intensity and diminished with continued therapy.¹⁶ In addition to a favorable tolerability profile, this study demonstrates that A/BPO 0.3%/2.5% is ef cacious in moderate to severe acne, males and females, and both children (ages 12 – 17 years old) and adults. This makes A/BPO 0.3%/2.5% an ideal foundational topical therapy for a wide range of acne vulgaris patients.

This study was funded by Galderma R&D. Dr. William Werschler is a clinical investigator, speaker, advisor and consultant for Galderma. Dr. Linda Stein Gold is a clinical investigator, speaker, advisor, and consultant for Galderma.

The authors wish to thank Valerie Sanders from Sanders Medical Writing for her writing assistance in preparing this manuscript.