This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on HighWire  • Citing articles on Web of Science (5)  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in this journal  Topic Collections  • Randomized Controlled Trial  • Alert me on articles by topic  Social Bookmarking   What's this?

A Multicenter, Double-blind, Randomized, Parallel-Group Study

James Leyden, MD; Diane M. Thiboutot, MD; Alan R. Shalita, MD; Guy Webster, MD, PhD; Kenneth Washenik, MD, PhD; Bruce E. Strober, MD, PhD; Jerome Shupack, MD

Arch Dermatol. 2006;142:605-612.

Objective  To evaluate the efficacy of 3 maintenance regimens (topical tazarotene, oral minocycline hydrochloride, or both) in sustaining improvement in acne.

Design  Multicenter, open-label treatment phase followed by double-blind, randomized, parallel-group maintenance phase.

Setting  Ambulatory patients in research or referral centers.

Patients  Volunteer sample of 189 patients with moderately severe to severe acne vulgaris (110 entered maintenance phase, 90 completed, and 2 discontinued because of adverse events).

Interventions  All patients were treated with 0.1% tazarotene gel (each evening) and a 100-mg capsule (twice daily) of minocycline hydrochloride for up to 12 weeks. Patients with 75% or greater global improvement at week 12 were randomly assigned to 12 weeks of maintenance therapy with tazarotene gel plus placebo capsules, vehicle gel plus minocycline capsules, or tazarotene gel plus minocycline capsules.

Main Outcome Measures  Overall disease severity, global improvement, and lesion counts.

Results  All regimens were effective in sustaining improvements in acne. After 12 weeks of maintenance therapy, the mean reductions from baseline in noninflammatory and inflammatory lesion count, respectively, were 60% and 54% with tazarotene, 52% and 66% with minocycline, and 64% and 66% with tazarotene plus minocycline. At week 24, more than 80% of patients in each group had maintained a 50% or greater global improvement from baseline, and more than 50% had maintained a 75% or greater global improvement.

Conclusions  A high percentage of patients with moderately severe to severe acne can maintain improvement in their condition with topical retinoid monotherapy. Maintenance with combination tazarotene and minocycline therapy showed a trend for greater efficacy but no statistical significance vs tazarotene alone. Topical retinoid monotherapy should be considered for maintenance to help minimize antibiotic exposure.

Author Affiliations: Skin Study Center, Broomall, Pa (Dr Leyden); Pennsylvania State University College of Medicine, Hershey (Dr Thiboutot); State University of New York Downstate Medical Center, Brooklyn (Dr Shalita); Jefferson Medical College, Philadelphia, Pa (Dr Webster); and New York University School of Medicine, New York (Drs Washenik, Strober, and Shupack). Dr Webster is currently with Jefferson Medical College, Hockessin, Del. Dr Washenik is currently with the Bosley Medical Group, Beverly Hills, Calif.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Adapalene Gel, 0.1%, as Maintenance Therapy for Acne Vulgaris: A Randomized, Controlled, Investigator-Blind Follow-up of a Recent Combination Study
Diane M. Thiboutot, Alan R. Shalita, Paul S. Yamauchi, Catherine Dawson, Nabil Kerrouche, Stéphanie Arsonnaud, and Sewon Kang
Arch Dermatol. 2006;142(5):597-602.
ABSTRACT | FULL TEXT  

Acne Maintenance Therapy: Expanding the Role of Topical Retinoids?
Lee T. Zane
Arch Dermatol. 2006;142(5):638-640.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Acne maintenance therapy: expanding the role of topical retinoids?
Zane
Arch Dermatol 2006;142:638-640.
FULL TEXT