side effects. Many clinicians ask about use of topical clascoterone with other topical agents for AV. Although not formally studied, my usual preference is to use clascoterone 1% cream during the daytime and a topical retinoid or topical retinoid-benzoyl peroxide combination formulation in the evening (such as bedtime), coupled with appropriate skin care.
A new FDA-approved topical combination formulation incorporates both encapsulated benzoyl peroxide and encapsulated tretinoin in the same cream for acne, with favorable efficacy and skin tolerability; the encapsulation technology circumvents the degradation of tretinoin by benzoyl peroxide.6 There have been improved specialized lotion formulations with either tretinoin or tazarotene for acne that reduce potential for skin irritation without loss of clinical efficacy.7,8 Topical trifarotene is a newer topical retinoid that is formally FDA-approved based on phase 3 studies for both facial and truncal acne.9 Another advance is topical minocycline 4% foam which is FDA-approved for AV, with pivotal trial data showing avoidance of systemic adverse effects that are sometimes seen with oral minocycline.10 Lastly, a triple combination of benzoyl peroxide, adapalene, and clindamycin formulated in a gel vehicle (IDP-126) is in development for AV; thus far, highly favorable efficacy as compared to the paired active components, and good skin tolerability, have been demonstrated in studies to date with IDP-126.11
As AV remains one of the most common skin disorders encountered in clinical practice, it is important that dermatology clinicians remain knowledgeable about new developments for AV including new compounds, vehicle formulations, and combination products. I am encouraged by the continued desire of both clinical and basic science researchers to develop new topical agents and formulations for AV that expand our menu of choices and help us to optimize therapeutic outcomes. In addition, I hope that efforts to increase affordability and access to these newer therapies for AV and other disease states will be successful.
A new FDA-approved topical combination formulation incorporates both encapsulated benzoyl peroxide and encapsulated tretinoin in the same cream for acne, with favorable efficacy and skin tolerability; the encapsulation technology circumvents the degradation of tretinoin by benzoyl peroxide.6 There have been improved specialized lotion formulations with either tretinoin or tazarotene for acne that reduce potential for skin irritation without loss of clinical efficacy.7,8 Topical trifarotene is a newer topical retinoid that is formally FDA-approved based on phase 3 studies for both facial and truncal acne.9 Another advance is topical minocycline 4% foam which is FDA-approved for AV, with pivotal trial data showing avoidance of systemic adverse effects that are sometimes seen with oral minocycline.10 Lastly, a triple combination of benzoyl peroxide, adapalene, and clindamycin formulated in a gel vehicle (IDP-126) is in development for AV; thus far, highly favorable efficacy as compared to the paired active components, and good skin tolerability, have been demonstrated in studies to date with IDP-126.11
As AV remains one of the most common skin disorders encountered in clinical practice, it is important that dermatology clinicians remain knowledgeable about new developments for AV including new compounds, vehicle formulations, and combination products. I am encouraged by the continued desire of both clinical and basic science researchers to develop new topical agents and formulations for AV that expand our menu of choices and help us to optimize therapeutic outcomes. In addition, I hope that efforts to increase affordability and access to these newer therapies for AV and other disease states will be successful.
References
1. Del Rosso JQ, Kircik LH, Stein Gold L, Thiboutot D, et al. J Drugs Dermatol. 2020;19(3 Suppl 1):s30-35.
2. Prescribing information. Winlevi (clascoterone) cream for topical use. Initial approval in 2020. Cassiopea/Sun Pharmaceuticals, accessed March 2022. 3. Hebert A, Thiboutot D, Stein Gold L, et al. JAMA Dermatol. 2020;156(6):61-630.
4. Eichenfield L, Hebert A, Stein Gold L, et al. J Am Acad Dermatol. 2020;83(2):477-485.
5. Center for Drug Evaluation and Research. Clascoterone 1% cream, NDA/BLA Multidisciplinary Review and Evaluation: NDA 213433.
6. Prescribing information. Twyneo (tretinoin and benzoyl peroxide) cream for topical use. Initial approval in 2021. Sol-Gel Technologies/Galderma Laboratories, accessed March 2022.
7. Prescribing information. Altreno (tretinoin) lotion for topical use. Initial approval in 1973; updated 2020. Bausch Health Companies, accessed March 2022.
8. Prescribing information. Arazlo (tazarotene) lotion for topical use. Initial approval in 1997; updated 2021. Bausch Health Companies, accessed March 2022.
9. Prescribing information. Aklief (trifarotene) cream for topical use. Initial approval in 2019. Galderma Laboratories, accessed March 2022.
10. Prescribing information. Amzeeq (minocycline) foam for topical use. Initial approval in 1971 (oral form); updated 2019. Foamix Pharmaceuticals/Journey Pharmaceuticals, accessed March 2022.
11. Poster presentation. IDP-126. Fall Clinical Dermatology, Las Vegas, Nevada, October 2021.
2. Prescribing information. Winlevi (clascoterone) cream for topical use. Initial approval in 2020. Cassiopea/Sun Pharmaceuticals, accessed March 2022. 3. Hebert A, Thiboutot D, Stein Gold L, et al. JAMA Dermatol. 2020;156(6):61-630.
4. Eichenfield L, Hebert A, Stein Gold L, et al. J Am Acad Dermatol. 2020;83(2):477-485.
5. Center for Drug Evaluation and Research. Clascoterone 1% cream, NDA/BLA Multidisciplinary Review and Evaluation: NDA 213433.
6. Prescribing information. Twyneo (tretinoin and benzoyl peroxide) cream for topical use. Initial approval in 2021. Sol-Gel Technologies/Galderma Laboratories, accessed March 2022.
7. Prescribing information. Altreno (tretinoin) lotion for topical use. Initial approval in 1973; updated 2020. Bausch Health Companies, accessed March 2022.
8. Prescribing information. Arazlo (tazarotene) lotion for topical use. Initial approval in 1997; updated 2021. Bausch Health Companies, accessed March 2022.
9. Prescribing information. Aklief (trifarotene) cream for topical use. Initial approval in 2019. Galderma Laboratories, accessed March 2022.
10. Prescribing information. Amzeeq (minocycline) foam for topical use. Initial approval in 1971 (oral form); updated 2019. Foamix Pharmaceuticals/Journey Pharmaceuticals, accessed March 2022.
11. Poster presentation. IDP-126. Fall Clinical Dermatology, Las Vegas, Nevada, October 2021.
