For management of acne, most clinicians have stopped prescribing benzoyl peroxide (PBO) or clindamycin (CL) as monotherapy, but many may wonder whether any combination formulation has advantages over the others. According to a recent meta-analysis of data for BPO/CL, BPO, and CL formulations, the combinations outperform monotherapy, while 2.5% BPO/CL appears to offer some advantages over 5% BPO/CL.
The analysis, to appear as a “Case Letter” in the Journal of the American Academy of Dermatology, included 126 randomized controlled trials involving 1,069 subjects receiving 5% BPO/CL, 872 subject receiving 2.5% BPO/CL, 1,690 subjects receiving BPO, 1,329 subjects receiving CL, and 777 subjects receiving placebo. At weeks 10 through 12, 2.5% BPO/CL demonstrated statistically greater reduction in noninflammatory lesion counts than any other therapy and demonstrated a percent reduction in inflammatory lesions that was similar to that for 5% BPO/CL. The 2.5% BPO/CL formulation had statistically significantly greater absolute reductions in lesion counts compared to the other therapies.
The authors note that there are limitation to meta-analyses, but they conclude that 2.5% BPO/CL is at least comparable to and possibly has advantages over 5% BPO/CL formulations.
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