Efficacy and safety of oral therapy combined with doxycycline in combination with the topical use of adapalene and benzoyl peroxide in the treatment of acne

Currently, there are a limited number of possibilities in the treatment of severe forms of acne, with the exception of the use of systemic retinoids (isotretinonin). A multicentre randomized, double-blind, controlled study by researchers in the United States evaluated the efficacy and safety of the combination therapy, which included a fixed combination of 0.1% adapalene gel and 2.5 % benzoyl peroxide in combination with doxycycline cyclate, which has been prescribed at a dose of 100 mg once a day, in patients suffering from severe acne.

In total, the study involved 459 patients who were randomized 1: 1 to receive doxycycline cyclate 100 mg once daily and either a combination of adapalene / benzoyl peroxide or just an ointment base once a day for 12 weeks.

At the end of 2 weeks of treatment, the effectiveness of the combination therapy with doxycycline + adapalene / benzoyl peroxide was already noted compared to the control group in terms of total number of foci, number of inflammatory foci and non-inflammatory foci (all p is less than 0.005). At the 12th week of treatment, this association exceeded the baseline doxycycline + in terms of reduction in the total number of foci, the number of inflammatory foci and non-inflammatory foci (additional benefits 23%, 24% and 21%, respectively ). In addition, in patients in the active group, significantly more overall success of the treatment and overall patient satisfaction with the treatment (all p values are less than 0.001) were noted. During digital photography by ultraviolet fluorescence, a rapid decrease in the number of Propionibacterium acnes was detected in the study group, especially during the first 4 weeks of treatment.

Thus, the results of the study showed evidence of the effectiveness of the combination of doxycycline and adapalene / benzoyl peroxide in the treatment of severe acne compared to monotherapy with doxycycline inside..