RESULTS
A total of 13 articles met the inclusion criteria for this review (Figure 1). These studies represented 226,019 acne patients, and study outcomes are summarized in Table 1. Qualitative assessment for randomized interventional and observational studies is reported in Supplemental Tables 1 and 2, respectively.
Common Primary Endpoint Measures
From the examined studies, the most common primary endpoint was the change in inflammatory lesions from baseline. This was measured by the absolute change or percent change of inflammatory lesions from baseline. Some studies also included the change in total lesion count from baseline as additional co-primary endpoints.
Another commonly used outcome measure was the Investigator’s Global Assessment (IGA), a 5-point scale where 0 equals clear and 4 equals severe. For example, a study defined IGA treatment success as a score of 0 (clear) or 1 (mostly clear) plus a two-grade improvement from baseline at 12 weeks.8 Other assessment tools included the Evaluator's Global Severity Assessment (EGSA), a 6-point scale where 0 equals clear and 5 equals very severe, where a study defined treatment success as a score of 0 (clear) or 1 (almost clear) at 12 weeks.9
Oral Tetracyclines
Sarecycline
Sarecycline is a novel, narrow-spectrum, oral tetracycline that inhibits bacterial protein synthesis by impeding the 30S ribosomal subunit; it also exhibits anti-inflammatory properties by inhibiting neutrophil chemotaxis and matrix metalloproteinases.2,3 Sarecycline was developed to specifically treat acne. Similar to other tetracyclines, sarecycline is composed of four six-carbon rings; however, sarecycline is unique because it has been modified at the C-7 position with a distinctive aminomethyl functional group.10
Common Primary Endpoint Measures
From the examined studies, the most common primary endpoint was the change in inflammatory lesions from baseline. This was measured by the absolute change or percent change of inflammatory lesions from baseline. Some studies also included the change in total lesion count from baseline as additional co-primary endpoints.
Another commonly used outcome measure was the Investigator’s Global Assessment (IGA), a 5-point scale where 0 equals clear and 4 equals severe. For example, a study defined IGA treatment success as a score of 0 (clear) or 1 (mostly clear) plus a two-grade improvement from baseline at 12 weeks.8 Other assessment tools included the Evaluator's Global Severity Assessment (EGSA), a 6-point scale where 0 equals clear and 5 equals very severe, where a study defined treatment success as a score of 0 (clear) or 1 (almost clear) at 12 weeks.9
Oral Tetracyclines
Sarecycline
Sarecycline is a novel, narrow-spectrum, oral tetracycline that inhibits bacterial protein synthesis by impeding the 30S ribosomal subunit; it also exhibits anti-inflammatory properties by inhibiting neutrophil chemotaxis and matrix metalloproteinases.2,3 Sarecycline was developed to specifically treat acne. Similar to other tetracyclines, sarecycline is composed of four six-carbon rings; however, sarecycline is unique because it has been modified at the C-7 position with a distinctive aminomethyl functional group.10
