The American Academy of Dermatology published the much-anticipated new guidelines for diagnosing and treating acne in adolescent and adult patients. To develop the guidelines, a work group of 17 recognized acne experts, 1 general practitioner, 1 pediatrician, and 1 patient was convened to determine the scope of the guidelines and identify clinical questions in the diagnosis and management of acne vulgaris.
The committee analyzed 242 newly identified clinical questions from 2 online databases from May 2006 to September 2014. Then it graded the evidence based on the quality of methodology and the overall focus of the evidence using a 3-point scale. The guidelines discuss various acne treatments, including topical therapies, systemic agents, and physical modalities, including lasers and photodynamic therapy. In addition, grading/classification system, microbiology and endocrinology testing, complementary/alternative therapies, and the role of diet are reviewed. The guidelines do not examine the treatment of acne sequelae (eg, scarring or postinflammatory dyschromia).
The committee concluded that combining 2 or more treatment options is optimal for most patients. The guidelines include a table that discusses recommendations for therapies used in combination.
In addition, there is “limited evidence to recommend the use and benefit of physical modalities for the routine treatment of acne, including pulsed dye laser, glycolic acid peels, and salicylic acid peels.” The committee also noted that more research is needed in the areas of alternative therapies, such as herbals, and the role of diet in acne. “Given the current data, no specific dietary changes are recommended in the management of acne. Emerging data suggest that high glycemic index diets may be associated with acne. Limited evidence suggests that some dairy, particularly skim milk, may influence acne,” they reported.
Finally, the investigators noted that they have described “the significant progress that has been made in understanding the pathogenesis and treatment of acne, but there are still large gaps in our knowledge base.” The guidelines include a table that addresses some important current gaps in research.
“The acne guidelines are based on specific clinical questions and a careful review of the literature. ‘How should acne be treated?’ was not one of the clinical questions,” noted Steven R. Feldman, MD, PhD, who is with the Center for Dermatology Research and the Departments of Dermatology, Pathology and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC. He is also the chief medical editor of The Dermatologist.
“The review provides an acne treatment algorithm that leaves, appropriately, a lot of room for clinicians to use their good judgment. For example, the guideline lists 5 potential approaches for the first-line treatment of moderate acne. But given the many available options of specific products used within those approaches, there are almost infinite treatment variations that could fall within this guideline,” he said.
Dr Feldman pointed out that there is good advice about when to do cultures (when there is suspicion of gram-negative folliculitis) and when to do endocrine testing (when, in addition to acne, the patient has at least one other sign of hyperandrogenism). “The guideline also provides detailed descriptive information about the benefits, risks, and strength of evidence for the available treatment options,” he said.
For more information and to read the full text of the guidelines, please visit https://www.jaad.org/article/S0190-9622(15)02614-6/fulltext.
New Plaque Psoriasis Treatment Approved
A prescription topical steroid has received FDA approval for the treatment of mild to moderate plaque psoriasis in patients 18 years of age and older. Betamethasone dipropionate (Sernivo) Spray, 0.05%, from Promius Pharma, LLC, US, a subsidiary of Dr. Reddy’s, will be available next quarter.
The company conducted 2 multicenter, randomized, double-blind, vehicle-controlled clinical trials in participants aged 18 years and older with moderate plaque psoriasis to evaluate the safety and efficacy of the spray. In both trials, randomized participants applied betamethasone dipropionate spray, 0.05%, or vehicle spray to the affected areas twice daily for 28 days. Enrolled participants had body surface area of involvement between 10% to 20%, and an Investigator’s Global Assessment (IGA) score of 3 (moderate). Efficacy was assessed as the proportion of participants who were considered a treatment success (defined as having an IGA score of 0 or 1 [clear or almost clear] and at least a 2-scale reduction from baseline). Treatment success was achieved in significantly more participants using betamethasone dipropionate spray, 0.05%, than vehicle at both day 15 and day 29 across both studies. At day 29 in Studies 1 and 2, the betamethasone dipropionate spray, 0.05%, achieved treatment success of 42.7% and 34.5% compared to vehicle success rates of 11.7% and 13.6%, respectively (P<.001).
The American Academy of Dermatology published the much-anticipated new guidelines for diagnosing and treating acne in adolescent and adult patients. To develop the guidelines, a work group of 17 recognized acne experts, 1 general practitioner, 1 pediatrician, and 1 patient was convened to determine the scope of the guidelines and identify clinical questions in the diagnosis and management of acne vulgaris.
The committee analyzed 242 newly identified clinical questions from 2 online databases from May 2006 to September 2014. Then it graded the evidence based on the quality of methodology and the overall focus of the evidence using a 3-point scale. The guidelines discuss various acne treatments, including topical therapies, systemic agents, and physical modalities, including lasers and photodynamic therapy. In addition, grading/classification system, microbiology and endocrinology testing, complementary/alternative therapies, and the role of diet are reviewed. The guidelines do not examine the treatment of acne sequelae (eg, scarring or postinflammatory dyschromia).
The committee concluded that combining 2 or more treatment options is optimal for most patients. The guidelines include a table that discusses recommendations for therapies used in combination.
In addition, there is “limited evidence to recommend the use and benefit of physical modalities for the routine treatment of acne, including pulsed dye laser, glycolic acid peels, and salicylic acid peels.” The committee also noted that more research is needed in the areas of alternative therapies, such as herbals, and the role of diet in acne. “Given the current data, no specific dietary changes are recommended in the management of acne. Emerging data suggest that high glycemic index diets may be associated with acne. Limited evidence suggests that some dairy, particularly skim milk, may influence acne,” they reported.
Finally, the investigators noted that they have described “the significant progress that has been made in understanding the pathogenesis and treatment of acne, but there are still large gaps in our knowledge base.” The guidelines include a table that addresses some important current gaps in research.
“The acne guidelines are based on specific clinical questions and a careful review of the literature. ‘How should acne be treated?’ was not one of the clinical questions,” noted Steven R. Feldman, MD, PhD, who is with the Center for Dermatology Research and the Departments of Dermatology, Pathology and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC. He is also the chief medical editor of The Dermatologist.
“The review provides an acne treatment algorithm that leaves, appropriately, a lot of room for clinicians to use their good judgment. For example, the guideline lists 5 potential approaches for the first-line treatment of moderate acne. But given the many available options of specific products used within those approaches, there are almost infinite treatment variations that could fall within this guideline,” he said.
Dr Feldman pointed out that there is good advice about when to do cultures (when there is suspicion of gram-negative folliculitis) and when to do endocrine testing (when, in addition to acne, the patient has at least one other sign of hyperandrogenism). “The guideline also provides detailed descriptive information about the benefits, risks, and strength of evidence for the available treatment options,” he said.
For more information and to read the full text of the guidelines, please visit https://www.jaad.org/article/S0190-9622(15)02614-6/fulltext.
New Plaque Psoriasis Treatment Approved
A prescription topical steroid has received FDA approval for the treatment of mild to moderate plaque psoriasis in patients 18 years of age and older. Betamethasone dipropionate (Sernivo) Spray, 0.05%, from Promius Pharma, LLC, US, a subsidiary of Dr. Reddy’s, will be available next quarter.
The company conducted 2 multicenter, randomized, double-blind, vehicle-controlled clinical trials in participants aged 18 years and older with moderate plaque psoriasis to evaluate the safety and efficacy of the spray. In both trials, randomized participants applied betamethasone dipropionate spray, 0.05%, or vehicle spray to the affected areas twice daily for 28 days. Enrolled participants had body surface area of involvement between 10% to 20%, and an Investigator’s Global Assessment (IGA) score of 3 (moderate). Efficacy was assessed as the proportion of participants who were considered a treatment success (defined as having an IGA score of 0 or 1 [clear or almost clear] and at least a 2-scale reduction from baseline). Treatment success was achieved in significantly more participants using betamethasone dipropionate spray, 0.05%, than vehicle at both day 15 and day 29 across both studies. At day 29 in Studies 1 and 2, the betamethasone dipropionate spray, 0.05%, achieved treatment success of 42.7% and 34.5% compared to vehicle success rates of 11.7% and 13.6%, respectively (P<.001).
The American Academy of Dermatology published the much-anticipated new guidelines for diagnosing and treating acne in adolescent and adult patients. To develop the guidelines, a work group of 17 recognized acne experts, 1 general practitioner, 1 pediatrician, and 1 patient was convened to determine the scope of the guidelines and identify clinical questions in the diagnosis and management of acne vulgaris.
The committee analyzed 242 newly identified clinical questions from 2 online databases from May 2006 to September 2014. Then it graded the evidence based on the quality of methodology and the overall focus of the evidence using a 3-point scale. The guidelines discuss various acne treatments, including topical therapies, systemic agents, and physical modalities, including lasers and photodynamic therapy. In addition, grading/classification system, microbiology and endocrinology testing, complementary/alternative therapies, and the role of diet are reviewed. The guidelines do not examine the treatment of acne sequelae (eg, scarring or postinflammatory dyschromia).
The committee concluded that combining 2 or more treatment options is optimal for most patients. The guidelines include a table that discusses recommendations for therapies used in combination.
In addition, there is “limited evidence to recommend the use and benefit of physical modalities for the routine treatment of acne, including pulsed dye laser, glycolic acid peels, and salicylic acid peels.” The committee also noted that more research is needed in the areas of alternative therapies, such as herbals, and the role of diet in acne. “Given the current data, no specific dietary changes are recommended in the management of acne. Emerging data suggest that high glycemic index diets may be associated with acne. Limited evidence suggests that some dairy, particularly skim milk, may influence acne,” they reported.
Finally, the investigators noted that they have described “the significant progress that has been made in understanding the pathogenesis and treatment of acne, but there are still large gaps in our knowledge base.” The guidelines include a table that addresses some important current gaps in research.
“The acne guidelines are based on specific clinical questions and a careful review of the literature. ‘How should acne be treated?’ was not one of the clinical questions,” noted Steven R. Feldman, MD, PhD, who is with the Center for Dermatology Research and the Departments of Dermatology, Pathology and Public Health Sciences at Wake Forest University School of Medicine in Winston-Salem, NC. He is also the chief medical editor of The Dermatologist.
“The review provides an acne treatment algorithm that leaves, appropriately, a lot of room for clinicians to use their good judgment. For example, the guideline lists 5 potential approaches for the first-line treatment of moderate acne. But given the many available options of specific products used within those approaches, there are almost infinite treatment variations that could fall within this guideline,” he said.
Dr Feldman pointed out that there is good advice about when to do cultures (when there is suspicion of gram-negative folliculitis) and when to do endocrine testing (when, in addition to acne, the patient has at least one other sign of hyperandrogenism). “The guideline also provides detailed descriptive information about the benefits, risks, and strength of evidence for the available treatment options,” he said.
For more information and to read the full text of the guidelines, please visit https://www.jaad.org/article/S0190-9622(15)02614-6/fulltext.
New Plaque Psoriasis Treatment Approved
A prescription topical steroid has received FDA approval for the treatment of mild to moderate plaque psoriasis in patients 18 years of age and older. Betamethasone dipropionate (Sernivo) Spray, 0.05%, from Promius Pharma, LLC, US, a subsidiary of Dr. Reddy’s, will be available next quarter.
The company conducted 2 multicenter, randomized, double-blind, vehicle-controlled clinical trials in participants aged 18 years and older with moderate plaque psoriasis to evaluate the safety and efficacy of the spray. In both trials, randomized participants applied betamethasone dipropionate spray, 0.05%, or vehicle spray to the affected areas twice daily for 28 days. Enrolled participants had body surface area of involvement between 10% to 20%, and an Investigator’s Global Assessment (IGA) score of 3 (moderate). Efficacy was assessed as the proportion of participants who were considered a treatment success (defined as having an IGA score of 0 or 1 [clear or almost clear] and at least a 2-scale reduction from baseline). Treatment success was achieved in significantly more participants using betamethasone dipropionate spray, 0.05%, than vehicle at both day 15 and day 29 across both studies. At day 29 in Studies 1 and 2, the betamethasone dipropionate spray, 0.05%, achieved treatment success of 42.7% and 34.5% compared to vehicle success rates of 11.7% and 13.6%, respectively (P<.001).
