The role of combined oral contraceptives containing norgestimate for acne vulgaris treatment: a review

Abstract

Introduction

Both Food and Drugs Administration and European Medicine Agency (EMA) approve the use of a triphasic combined oral contraceptive (COC) containing ethinyl-oestradiol (EE) and norgestimate (NGM) for acne vulgaris treatment in women requiring an effective contraception. COCs can target sebum production and may also play a role in decreasing follicular hyperkeratinisation.

Results

Specific advantages of the use of an anti-androgenic progestin such as NGM in this condition are presented in this review, including the lowest venous thrombosis risk in the COCs scenario, as established by the EMA, associated with a very satisfactory cycle control. The results of aggregate analysis of published data (n = 163 vs. n = 161 treated subjects) demonstrate a significant effect in comparison with the placebo of a greater than 50% reduction, in terms of inflammatory lesions (from 19.0 to 8.2), comedones (from 35.2 to 17.7) and total lesions (from 54.3 to 25.9) count.

Conclusions

The choice of a triphasic combination of EE/NGM seems a referenced, highly effective, easy-to-use and safe therapeutic approach for acne vulgaris, alone or in combination with different targeted drugs.

SHORT CONDENSATION

Triphasic ethinyl-oestradiol and norgestimate is on label for mild to moderate acne vulgaris treatment worldwide, in women requiring an effective contraception. This combination demonstrated a significant effect in comparison with the placebo of a greater than 50% reduction, in terms of inflammatory lesions, comedones and total lesions count.

摘要

简介：美国食品药品监督管理局（Food and Drugs Administration）和欧洲药品管理局（European Medicine Agency, EMA）均批准使用含有炔雌醇（EE）和诺孕酯（NGM）的三相联合口服避孕药（COC）治疗需要有效避孕的女性寻常痤疮。COCs可以靶向皮脂生成, 也可能在减少毛囊过度角化中发挥作用。

结果：本综述介绍了在这种情况下使用抗雄激素孕激素（如NGM）的具体优势, 包括EMA确定的COCs情况下的最低静脉血栓形成风险, 以及非常令人满意的周期控制。已发表数据的汇总分析结果（n=163 vs.n=161接受治疗的受试者）表明, 与安慰剂相比, 在炎症病变（从19.0到8.2）、粉刺（从35.2到17.7）和总病变（从54.3到25.9）计数方面, 有显著的效果, 减少了50%以上。

结论：选择EE/NGM的三相组合似乎是治疗寻常痤疮的一种参考、高效、易用和安全的方法, 无论是单独治疗还是与不同的靶向药物联合治疗。

短冷凝

三相乙炔雌二醇和诺孕酯被列为全球轻度至中度寻常痤疮治疗的标签, 适用于需要有效避孕的女性。与安慰剂相比, 该组合在炎症病变、粉刺和总病变数方面显示出显著的效果, 减少了50%以上。

Keywords:

• Combined hormonal contraceptives
• acne vulgaris
• norgestimate
• ethinylestradiol
• hyperandrogenism
• pill

Disclosure statement

G. Grandi received honoraria for sponsored lectures and participation in advisory boards from Bayer AG, Teva/Theramex, Exeltis, Organon, Italfarmaco, Opocrin and Gedeon Richter. The authors have no other relevant affiliations or financial involvement with any organisation or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

G. Grandi received financial support from Exeltis Italy (Peschiera Borromeo, Milan, Italy) for the preparation of this paper.