AARS Hot Topics - August 1, 2017 Issue


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This is a semi-monthly compilation of peer-review literature and online updates in acne and rosacea covering industry press, new medical research and what patients and your peers are talking about in patient counseling tips.

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Industry News

  • Sebacia announced that the company has completed a $20 million Series D financing and closed a $16 million debt facility with Hercules Capital to continue the development of a proprietary microparticle treatment for moderate-to-severe acne.
  • Sol-Gel Technologies Ltd. has announced positive results from its phase 2 clinical trial of its topical drug candidate TWIN for treating acne vulgaris. Sol-Gel also plans to use results from the encapsulated tretinoin arms of the study to develop its single agent, encapsulated tretinoin drug product candidate, SIRS-T, as a first-line treatment for adult and adolescent patients with acne, according to the release.

New Medical Research

  • A recent study raises the hypothesis that psychiatric disorders associated with isotretinoin are related to a class effect of retinoids, as a signal emerges for alitretinoin. Complementary studies are necessary to estimate the risk and further determine at-risk populations.
  • Open-label study evaluated subject satisfaction after use of BPO 5% gel in combination with liquid cleanser and moisturizer SPF 30 and found that the combination of BPO 5% gel with liquid cleanser and moisturizer SPF 30 resulted in high levels of subject satisfaction, good tolerability and treatment adherence.
  • After carrying out a detailed analysis of skin infiltrating T cells it was found that the data suggested that inhibition of pathogenic IL-17 via TNF blockade is associated with improvement in the immune dysregulation in HS and may provide a rationale for targeting IL-17 in the disease.
  • Azelaic acid 15% foam was effective in treating moderate truncal acne and facial acne in this pilot study. Given the efficacy and convenience of the foam vehicle, azelaic acid may be considered as a viable option for treatment of acne vulgaris, including on the trunk. Further studies are suggested in a larger population of patients, including adult females with acne.
  • A study was performed to determine the safety, efficacy, and ease of use of a botanical acne treatment gel in providing a reduction in inflammatory acne lesion erythema, elevation, and induration. Erythema and elevation were the most influential parameters in inflammatory lesion with improvement noted after 2 days of application.
  • An analysis assessed the relationship of age, sex, and race to treatment response with once-daily topical dapsone gel, 7.5%. Older age (≥18 years) and female sex were predictors of treatment response. These subgroups tended to have greater acne improvement in subgroup comparisons. Caucasian and non-Caucasian patients had similar responses. The safety profile of dapsone gel, 7.5% was similar across subgroups.

Clinical Reviews

  • The treatment of acne, especially severe acne, remains a challenge to dermatologists. Therapies include retinoids, antibiotics, hormones, lights, lasers, and various combinations of these modalities. Acne is currently considered a chronic rather than an adolescent condition. The appropriate treatment depends on the patient and the severity of disease. The purpose of this study was to review current therapies for acne of all severities and to introduce the 650-μs 1064-nm laser for the treatment of acne.
  • Diagnostic and therapeutic recommendations are presented based on a systematic literature search as well as an informal expert consensus of Swiss dermatologists and dermatosurgeons.
  • Use of the AGREE II Instrument during guideline development did not have as great an effect on guideline quality as might be expected. There is considerable room for improvement in acne treatment guidelines in order to satisfy the IOM trustworthiness criteria and avoid bias.
  • A retrospective analysis using the OptumInsight Clinformatics DataMart to characterize changes in prescribing behavior for systemic agents in the treatment of acne. Additional work to identify patients who would benefit most from alternative therapies such as spironolactone, oral contraceptives, or isotretinoin represents a potential opportunity to improve the care of patients with acne.
  • There is no consensus on isotretinoin monitoring tests and frequency, though the majority of dermatologists surveyed regarding laboratory monitoring practices while prescribing isotretinoin monitor a lipid panel and LFTs.

Patient Counseling / Communication

  • Myth: Itching is not a symptom of acne. Acne vulgaris typically is not considered to be a pruritic disease; however, many patients experience itching, which leads them to scratch their acne lesions, causing secondary bacterial infections and subsequent scarring, hypopigmentation, or hyperpigmentation of the involved skin. Although itching rarely is mentioned as a clinical feature of acne, pruritus can be an important contributory factor to the burden of disability and impaired quality of life in acne patients of all ages, and acne itching may be an important target for therapy.