Review of Tretinoin-Benzoyl Peroxide in The Treatment of Acne Vulgaris

October 2022 | Volume 21 | Issue 10 | 1098 | Copyright © October 2022


Published online September 26, 2022

doi:10.36849/JDD.6808

Rohan Singh BSa, Ajay Chatim BSa, Aman Kankaria BSa, Steven R. Feldman MD PhDa,b,c

aCenter for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, NC
bDepartment of Pathology, Wake Forest School of Medicine, Winston-Salem, NC
cDepartment of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC

Abstract
Background: Acne vulgaris has a multifactorial pathogenesis, and combination therapy is recommended in most patients. A tretinoin 0.1%/benzoyl peroxide 3% (Tret-BPO) cream which uses a core-shell encapsulation system to enhance the stability of both active ingredients recently received approval from the Food and Drug Administration (FDA).
Objective: To review the pharmacokinetics, efficacy, and safety of recently approved Tret-BPO.
Methods: A review of literature was conducted using the EMBASE, MEDLINE (Pubmed), and Clinicaltrials.gov databases in December 2021. Articles in English discussing the use of Tret-BPO in the treatment of acne vulgaris were included.
Results: In a phase 2 trial, Tret-BPO achieved Investigators Global Assessment (IGA) success more often (39.7%) than vehicle (12.3%; P<0.001). In 2 phase 3 trials, Tret-BPO had a higher success rate (Trial 1: 38.5% and Trial 2: 25.4%) when compared with vehicle (Trial 1: 11.5% and Trial 2: 14.7%; P<0.001 and P=0.017).
Limitation: This review was limited by the lack of clinical trials assessing the efficacy and safety of Tret-BPO compared with other acne treatments.
Conclusions: Tret-BPO is a safe and effective novel therapy for acne vulgaris. Poor adherence is a major hurdle in management; the combination of two separate first-line drugs may address this hurdle by decreasing the complexity of treatment regimens.

J Drugs Dermatol. 2022;21(10):1098-1103. doi:10.36849/JDD.6808

INTRODUCTION

The pathogenesis of acne vulgaris (AV) is multifactorial, and treatments are used in combination to address the multiple pathogenic mechanisms and concurrent non-inflammatory and inflammatory lesions.1,2 Topical retinoids and benzoyl peroxide are among the first line agents (Table 1; Table 2).4,6 Poor adherence to acne treatment is common and is exacerbated by the complexity of treatment regimens.

A combination product, tretinoin 0.1% and benzoyl peroxide 3% (Tret-BPO) cream is approved by the Food and Drug Administration (FDA) for the treatment of AV in patients 9 years of age and older.3 Benzoyl peroxide can oxidize and degrade tretinoin, depending on laboratory conditions, including the presence of light.4,6,7 The Tret-BPO cream uses an encapsulation system that may enhance the stability of both tretinoin and benzoyl peroxide.7

This narrative review will focus on the mechanism of action, pharmacokinetics, efficacy, and safety of the Tret-BPO combination drug in the treatment of AV.

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