Safety and Efficacy of Fixed-Dose Combination of Adapalene and Benzoyl Peroxide in Acne Vulgaris Treatment: A Systematic Review of Clinical Trials

Abstract

The Global Burden of Disease Study 2020 ranked acne vulgaris as the eighth most common skin condition, with a global estimated prevalence of 9.4%. The clinical presentation of acne vulgaris ranges from comedones to nodules and cysts. The main treatment options for acne are retinoids, antibiotics, and benzoyl peroxide (BPO). This study aimed to evaluate the reported efficacy and safety of the combination treatment with retinoid and benzoyl peroxide. Three databases (ScienceDirect, Google Scholar, and PubMed) were searched using keywords such as acne, adapalene/benzoyl peroxide, and randomized controlled trial, and specific search moods such as "Title and abstract" for PubMed and "Title, abstract, and keywords" for ScienceDirect. On Google Scholar, the "allintitle" option was utilized. The articles were searched for the years between 2003 and 2023. The eight trials selected for systematic review reported randomized controlled trials in 4,596 individuals with the first trials being conducted in February 2007 and the last one in May 2022. There were 52.8% females in the trials, and the trials reported a primary reduction of acne lesions (efficacy) from 27.5% to 70.2%. The occurrence of adverse effects was also variable (ranging from 2.7% to 57.9%), but these effects were mild and vanished with time. The results showed that the combination of adapalene and benzoyl peroxide is a safe and effective treatment.