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A comparison of the efficacy and tolerability of adapalene 0·1% gel versus tretinoin 0·025% gel in patients with acne vulgaris: a meta‐analysis of five randomized trials
Author(s) -
W.J. Cunliffe,
Michel Poncet,
Christian Loesche,
Michèle Verschoore
Publication year - 1998
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1046/j.1365-2133.1998.1390s2048.x
Subject(s) - acne , adapalene , tolerability , tretinoin , dermatology , medicine , randomized controlled trial , meta analysis , adverse effect , surgery , chemistry , retinoic acid , benzoyl peroxide , biochemistry , organic chemistry , polymerization , gene , polymer
The purpose of this meta‐analysis was to determine if adapalene 0·1% gel (Differin®) provided superior efficacy and better tolerability than tretinoin 0·025% gel in the treatment of acne vulgaris. All comparative studies, both published and unpublished, from the United States and Europe, that fulfilled rigorous protocol criteria (multicentre, randomized, investigator‐blind) were used. Five comparative studies met these criteria. In total, the meta‐analysis evaluated 900 patients (450 treated with adapalene 0·1% gel, 450 treated with tretinoin 0·025% gel) with mild‐to‐moderate acne from the combined clinical trials. To avoid study bias, the meta‐analysis used an intention‐to‐treat analysis. Statistical methodology for the meta‐analysis included analysis of covariance, analysis of variance and Cochran–Mantel–Haenszel test. All statistical tests were two‐sided, with the 0·05 probability level used to establish statistical significance, and 95% confidence intervals used to assess equivalence. Adapalene demonstrated equivalent efficacy to tretinoin in terms of reducing total lesion count. Adapalene demonstrated more rapid efficacy, as evidenced by a significant difference in the reduction of inflammatory and total lesions at week 1. Adapalene also demonstrated considerably greater local tolerability at all evaluation periods. The findings from this meta‐analysis suggest that adapalene 0·1% gel constitutes a pharmacologic advance over such classic retinoids as tretinoin for the treatment of acne vulgaris.