INTRODUCTION
Acne vulgaris (AV) is a complex, inflammatory, cutaneous disorder of the pilosebaceous unit that affects 9.4% of the global population,1,2 ranking it as the eighth most prevalent disease in the world.3 AV can persist into adulthood with 85% of impacted individuals being adolescents and young adults,4 and it has a higher prevalence among adult women than their male counterparts.5 More than 5.1 million Americans sought medical treatment for AV in 2013 with direct costs estimated to exceed 3 billion dollars.6 The condition is chronic, has a high potential for relapse and long-term sequelae, and its physical appearance contributes to the emotional and psychosocial burden of disease, impaired quality of life (QoL), low self-image,7 poor self-esteem, and increased social and emotional anxiety.8,9 Psychosocial impact on patients with AV is reported to be greater than that attributed to other dermatologic conditions (psoriasis and eczema)10 and equivalent to that for other debilitating conditions such as asthma, epilepsy, diabetes, or arthritis.11,12 Antibiotics have been a standard of care in treating AV for >5 decades.13,14 Oral antibiotics are recommended by the American Academy of Dermatology for the treatment of moderate and severe AV, and oral tetracyclines are used frequently for this condition. However, prolonged and repetitive use of broad-spectrum antibiotics, such as doxycycline and minocycline, have been associated with the development of antimicrobial resistance.15-19
Sarecycline is the first narrow-spectrum tetracycline-derived antibiotic approved by the US Food and Drug Administration (US FDA) for the treatment of inflammatory lesions of non-nodular moderate-to-severe AV, and it has a low potential to induce bacterial resistance.20-23 Two identically designed, pivotal, double-blind, randomized, placebo-controlled clinical trials demonstrated sarecycline to be efficacious and well-tolerated with a favorable safety profile.20 These studies assessed patient-reported outcomes (PROs) with the Skindex-16, and demon
Sarecycline is the first narrow-spectrum tetracycline-derived antibiotic approved by the US Food and Drug Administration (US FDA) for the treatment of inflammatory lesions of non-nodular moderate-to-severe AV, and it has a low potential to induce bacterial resistance.20-23 Two identically designed, pivotal, double-blind, randomized, placebo-controlled clinical trials demonstrated sarecycline to be efficacious and well-tolerated with a favorable safety profile.20 These studies assessed patient-reported outcomes (PROs) with the Skindex-16, and demon
