Acne Vulgaris Http

Combination Lymecycline, A/BPO Thwarts Acne

A combination of oral lymecycline and adapalene-benzoyl peroxide offers greater clinical benefit than lymecycline does alone for moderate to severe acne vulgaris, according to a recent study.

Combination therapy with a topical retinoid and antimicrobial agent is considered a preferred treatment approach for patients with acne vulgaris. And, previous studies have shown that combination topical adapalene and benzoyl peroxide (A/BPO) are more effective than either treatment alone. Tetracyclines, such as lymecycline, are the conventional treatment for cases that do not respond to topical therapy. Therefore, investigators hypothesized that a combination of these agents might offer enhanced efficacy.

Dr. Brigitte Dréno of Nantes (France) University Hospital and her colleagues performed a double-blind, randomized, controlled, parallel group trial to investigate the safety and efficacy of lymecycline combined with either A/BPO or the control vehicle ( Br. J. Dermatol. 2011 July 6 [doi: 10.1111/j.1365-2133.2011.10374.x]).

Patients were included from 32 investigational centers in nine countries; they could be of any race or sex, aged 12-35 years, and had to have moderate or severe acne vulgaris (Investigator Global Assessment score of 3 or 4 on a scale of 0-5). Also, the patients had to have at least 20 inflammatory lesions, 30 to 120 noninflammatory lesions, and no more than 3 nodulocystic lesions on the face (excluding the nose area).

A designated statistician randomized 378 patients to receive oral lymecycline (300 mg once daily in the morning) with either the A/BPO or vehicle gel, to be applied once daily in the evening for 12 weeks. After accounting for patients who discontinued the study, the final patient population consisted of 334 patients (170 in the lymecycline plus A/BPO group, and 164 in the lymecycline plus vehicle group).

Researchers measured safety and efficacy at baseline and at weeks 2, 4, 8 and 12. Specifically, they looked at the following:

• Total lesion count. At 2 weeks, the mean change in total lesion counts was –25.6% in the A/BPO plus lymecycline group, compared with –18.2% in the vehicle plus lymecycline group, a statistically significant difference, the researchers reported. By week 12, the median percent change from baseline was –74.1% in the A/BPO group, compared with –56.8% in the vehicle group.

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