Doxycycline vs. Minocycline for the Management of Acne

September 2011 | Volume 10 | Issue 9 | Editorials | 965 | Copyright © September 2011

Alan R. Shalita MD, Guy F. Webster MD PhD, Mitchell S. Wortzman PhD, Diane Nelson BSN MPH


Mitchell S. Wortzman, PhD, is Chief Scientific Officer of Medicis Pharmaceutical Company, Scottsdale, AZ and has stock options.
Alan R. Shalita, MD, is a consultant for Medicis, Allergan, DUSA, Johnson & Johnson, Galderma, Graceway, Quinova and Steifel (a GSK company). Guy F. Webster, MD, is a consultant for Medicis, Allergan, Galderma, Cutanea, GSK, Valocor, Tolmar, Vicept and Anterios. Diane B. Nelson, BSN, MPH, is an employee of Medicis Pharmaceutical Company, Scottsdale, AZ.


Alan R. Shalita MD,a Guy F. Webster MD PhD,b
Mitchell S. Wortzman PhD,c Diane B. Nelson BSN MPHc

aDepartment of Dermatology, SUNY Downstate Medical Center,
Brooklyn, NY
bDepartment of Dermatology, Jefferson Medical College,
Philadelphia, PA
cMedicis Pharmaceutical Company, Scottsdale, AZ


Doxycycline vs. Minocycline for the Management of Acne
I believe that the letter by Dr. Wortzman and his colleagues at Medicis was written in the spirit of constructive criticism and scientific debate.


The intent of my review article was not to advertise the "six important studies" of extended-release (ER) minocycline (SOLODYN® Medicis, Scottsdale, AZ), which is approved by the U.S. Food and Drug Administration (FDA)2 solely for treatment of inflammatory lesions of non-nodular, moderate-to-severe acne vulgaris.


In those studies referenced by Wortzman et al., 17.3 percent and 15.9 percent of subjects in the SOLODYN group were "clear" or "almost clear" according to the Evaluators Global Severity Assessment versus 7.9 percent and 9.5 percent of subjects who were clear or almost clear in the placebo group.


Surprisingly, the authors of the letter made no mention of these results.
However, I do not disagree with Dr. Wortzman and colleagues as to the need for a head-to-head study comparing ER minocycline versus ER doxyclycline for the treatment of acne vulgaris.
Further, I wholeheartedly invite Medicis to initiate such a study, one that will meet the high standards and statistical power required by the letter's authors.


Dr. Leon H. Kircik has served as an investigator, speaker, consultant or advisory board member for Allergan, Amgen, Astellas Pharma US, Colbar, CollaGenex, Connetics Corporation, Ferndale Laboratories, Galderma, Genentech, Intendis, Johnson & Johnson, Leo Pharma, 3M, Nano Bio, Novartis AG, Onset Therapeutics, OrthoNeutrogene, Promius, PharmaDerm, SkinMedica, Stiefel, Valeant, Warner-Chilcott; a speaker for Abbott Laboratories, Dermik, Embil, Innovail, Merck Serono and Triax; an investigator for Acambis, Asubio, Bayer HealthCare, Biolife, Biopelle, Brekenridge Pharma, Centocor, Combinatrix, Coria, Dow Pharmaceutical Sciences, Dusa, GSK, Health Point, Medicis, Nucryst, Obagi, QLT, Quatrix, TolerRx and UCB; and as a consultant for Laboratory Skin Care, Medical International Technologies and ZAGE.


Leon H. Kircik MDa,b
aMount Sinai Medical Center, New York, NY
bIndiana University School of Medicine, Indianapolis, IN