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| |  DG DISPATCH - EADV: Differin (Adapalene) Less Irritating Than Other Anti-acne Treatments By Cameron Johnston Special to DG News
GENEVA, SWITZERLAND -- October 18, 2000 -- Adapalene, a novel retinoid molecule with comedolytic properties, appears to cause significantly less skin irritation than many of the leading anti-acne medications. Adapalene has also been found effective in treating actinic keratosis and actinic lentigenes in older patients, reported two studies presented at the annual meeting of the European Association for the study of Dermatology and Venereology, held in Geneva, Switzerland. Investigators outlined the results of the first study, in which 36 healthy subjects (26 men, 10 women, mean age 30 years) were given skin tests with Differin cream (adapalene) (0.01%); Differin gel (0.01%); Erylik gel (tretinoin/erythromycin); Isotrexin (isotretinoin/erythromycin); Aknemycin (erythromycin); or white petroleum. The tests were conducted by applying a patch of each drug to either the back or the side of each subject, each day of the week, and then leaving them in place over the weekend. Measurements of the skin reaction were taken on a daily basis and then at the end of the weekend, to show the drugs’ effects after long-term exposure. The trial lasted a total of 21 days. The damage that results from the use of most other anti-acne medications comes entirely from direct damage to the epidermal layer and not as a result of any immunologic or allergic reaction. The severity of the reaction is measured according to the Cumulative Irritation Comparison Index, which is used to assess just such an effect when a new drug is being tested on a patient for the first time. Overall, it was found that adapalene was slightly more irritating than white petroleum but was significantly less irritating than tretinoin/erythromycin gel, isotretinoin/erythromycin gel or erythromycin solution. No subjects stopped using either white petroleum or adapalene due to adverse reactions. However, there were significant rates of discontinuation with each of the other comedolytics. All patients using tretinoin/erythromycin gel stopped using it by day 10; 35 out of 36 of those using isotretinoin/erythromycin stopped using it by day nine, and 35 out of 36 patients stopped using erythromycin solution by day 11. The comparison might be viewed with some caution, however, since at least one of the drugs, Isotrexin (isotretinoin/erythromycin), for example, is most commonly used in the treatment of severe acne, while Differin (adapalene) is indicated for the treatment of mild and moderate acne. Therefore, the drugs might not all have the same potency and would not be expected to have the same side effect profiles. Nonetheless, daily erythema scores showed that each of the drugs resulted in significantly more erythema than either petroleum or adalapene. Similarly, while the cumulative irritation index scores for tretinoin/erythromycin, erythromycin and isotretinoin/erythromycin were all in the order of 2.0-2.5 on a three-point scale, the comparable scores for adapalene were less than 0.5 and for white petroleum were less than 0.25 Overall, adapalene gel and cream while being slightly more irritating than white petroleum are significantly less irritating that the other agents. The results of this study clearly indicate that Adapalene gel and cream should be considered for first line treatment of acne vulgaris, the researchers concluded.
Related Link: Differin (adapalene).
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