Exploring a Triple-Combination Therapy for Acne Management
Featuring John Barbieri, MD, MBA, FAAD |
Director of the Advanced Acne Therapeutics Clinic
Brigham and Women's Hospital
Chestnut Hill, MA
In this episode of Topical Conversations, John Barbieri, MD, MBA, FAAD, gives an overview of a triple-combination topical therapy for acne comprising clindamycin, adapalene, and benzoyl peroxide, highlighting its efficacy, safety, and tolerability and how this formulation may impact patient adherence.
Efficacy
In phase 3 clinical trials, the success rates, as measured by the Investigator’s Global Assessment (IGA) of achieving clear or almost clear skin, were 50% for those using the treatment, compared to 20% for those using the vehicle. For context, most single-ingredient topical therapies show a delta of about 10% between the treatment and the vehicle. Fixed-dose combination treatments with 2 ingredients generally show a delta of around 20%. Therefore, the 30% delta observed with clindamycin/adapalene/benzoyl peroxide underscores its potential as a powerful option in acne therapy.
Meta-analysis findings
A meta-analysis that reviewed over 221 randomized controlled trials found that clindamycin/adapalene/benzoyl peroxide had the highest rates of effectiveness among all acne treatments evaluated. Earlier studies also demonstrated that this triple-combination therapy outperformed any of the dual-ingredient combinations.
Tolerability and safety profile
In addition to its efficacy, clindamycin/adapalene/benzoyl peroxide demonstrates a favorable tolerability profile. The phase 3 trials reported a discontinuation rate due to adverse effects of just 2.5%. For comparison, phase 3 studies of adapalene-benzoyl peroxide combinations reported discontinuation rates of about 2%, while tretinoin-benzoyl peroxide combinations had a rate of approximately 3.2%. The meta-analysis also indicated that this new treatment is relatively well-tolerated, on par with other topical retinoid or fixed-dose combination treatments.
Implications for patient adherence
This triple-combination therapy not only shows high efficacy and good tolerability but also has the potential to improve patient adherence. Studies have consistently shown that patients are more likely to adhere to fixed-dose combination products compared to using individual components separately. Improved adherence often leads to better outcomes in acne management, making this therapy a promising option for patients.
More from this series
Acne
Advances in Acne Treatment: 2024 Highlights and What to Watch for in 2025
Featuring John Barbieri, MD, MBA, FAAD
Acne
Exploring Emerging Dermatology Devices and Treatments in 2025
Featuring Stephen Lewellis, MD, PhD, FAAD
Dermatology
Dermatologist's Guide to Winter Skin Care: Practical Tips to Share With Patients
Featuring Charlie Dunn, MD
Atopic Dermatitis
Advances in Atopic Dermatitis: A 2024 Recap and 2025 Outlook
Featuring Peter Lio, MD
Related CME
ACNE, CME
FC24: A Roadmap for Clear Skin: Pathways to Put Acne in the Rearview Mirror: An Online Activity
20 min | Up to 0.5 CME credits
ACNE, CME
2024 Virtual Grand Rounds Session 6: May 1, 2024 - Treating Acne with Devices and Contact Dermatitis - What Allergens Should I Care about in 2024?
45 min | Up to 1 CME credits
ACNE, CME
Topical Therapies in Acne: Why the Mechanism of Action (MOA) Matters In Practice Decisions Online CME Activity
20 min | Up to 0.5 CME credits
Related Media
Powered by Polaris TMJames Q. Del Rosso
Karan Lal
John Barbieri
Elana Gotkine (HealthDay News)