Efficacy and tolerability of three topical acne treatments by body mass index: post hoc analysis including overweight and obese patients

Abstract

Background

Acne prevalence may be higher in overweight/obese individuals, potentially due to hormonal, inflammatory, and/or dietary factors. However, the effects of body mass index (BMI) on topical acne treatments are largely unknown.

Methods

Post hoc analyses of changes in inflammatory/noninflammatory lesions and treatment success were conducted using phase 3 data: clindamycin phosphate/benzoyl peroxide (CP/BPO) 1.2%/3.75% gel (NCT01701024); tretinoin 0.05% lotion (NCT02965456 and NCT02932306; pooled); and tazarotene 0.045% lotion (NCT03168321 and NCT03168334; pooled). Data were analyzed by BMI subgroups: <25kg/m² (underweight-to-normal), 25-<30kg/m² (overweight), and ≥30kg/m² (obese).

Results

Among participants analyzed (CP/BPO = 495; tretinoin = 1,636; tazarotene = 1,612), ∼20–25% were overweight and 15–20% were obese. At week 12, mean percent changes from baseline in inflammatory lesions were: CP/BPO (overweight: −63.2%, obese: −56.0%); tretinoin (−57.6%, −53.1%); tazarotene (−59.9%, −56.8%). Mean changes in noninflammatory lesions were: CP/BPO (−54.2%, −50.8%); tretinoin (−51.6%, −44.9%); tazarotene (−56.7%, −54.6%). Treatment success rates with active treatment ranged from 16.2% to 33.5% across BMI groups.

Conclusions

CP/BPO 1.2%/3.75% gel, tretinoin 0.05% lotion, and tazarotene 0.045% lotion were all effective in reducing acne lesions by ≥45% in overweight/obese patients with moderate-to-severe acne, comparable to the underweight-to-normal group. Efficacy of these topical acne treatments is not greatly impacted by BMI and may be affected more by the formulation.

Keywords:

• Topical
• acne
• BMI
• retinoid
• antibiotic
• phase 3
• tazarotene
• tretinoin
• clindamycin phosphate
• benzoyl peroxide

Disclosure statement

Jonette Keri has served on speaker's bureau for Vyne Therapeutics, on advisory board for Ortho Dermatologics, as a consultant to Almirall, and investigator to Galderma. Fran E. Cook-Bolden has served as consultant, speaker, investigator for Galderma, LEO Pharma, Almirall, Cassiopea, Ortho Dermatologics, Investigators Encore, Foamix, Hovione, Aclaris, Cutanea. Lawrence J. Green has served as investigator, consultant, or speaker for Almirall, Cassiopea, Galderma, Ortho Dermatologics, Sol Gel, Sun Pharma, and Vyne. Leon H. Kircik has acted as an investigator, advisor, speaker, and consultant for Ortho Dermatologics. Hilary Baldwin has served as advisor, investigator, and on speakers’ bureaus for Almirall, Cassiopea, Foamix, Galderma, Ortho Dermatologics, Sol Gel, and Sun Pharma. William Philip Werschler has served as an investigator for Ortho Dermatologics. Eric Guenin is an employee of Ortho Dermatologics and may hold stock and/or stock options in its parent company. Radhakrishnan Pillai and Varsha Bhatt are employees of Bausch Health US, LLC and may hold stock and/or stock options in its parent company.

Additional information

Funding

Medical writing support was provided by Prescott Medical Communications Group (Chicago, IL) with financial support from Ortho Dermatologics. Ortho Dermatologics is a division of Bausch Health US, LLC.