Fatma AYDIN, Tayyar CANTÜRK, Nilgün ŞENTÜRK, Ahmet Yaşar TURANLI

Akne vulgaris tedavisinde tretinoin %0.025 jel ve adapalene %0.1 jelin klinik etkilerinin karşılaştırılması

Adapalene, yeni bir naftoik asit türevi olup, retinoid benzeri aktivite gösterir. Çalışmamızda, akne vulgarism topikal tedavisinde, tretinoin %0.025 jel ile adapalene %0.1 jelin klinik etki ve yan etkilerini karşılaştırmayı amaçladık. Komedonal ve hafif inf-lamatuar akne vulgarisli 40 hasta, randomize olarak eşit sayıda iki gruba ayrıldı. Birinci gruba tretinoin %0.025 jel, ikinci gruba adapalene %0.1 jel uygulandı. Hastalar 12 halta sonunda lezyon sayıları ve yan etkileri açısından karşılaştırıldı. Çalışmamızda her iki ajanın açık komedon, papül ve püstül sayılarını eşit düzeyde azalttığı görülürken, kapalı komedon ve toplam lezyonların sayısını azaltmada (tretinoin de %54, adapalene de %70) adapalenenin daha etkili olduğu tespit edildi. Adapalenenin tretinoine göre yan etki po-tansiyelinin daha az ve tedavide hasta uyumunun daha iyi olduğu gözlendi. Sonuç ola-rak, adapalene %0.1 jel'in akne vulgaris tedavisinde, tretinoin %0.025 jel'e göre daha et-kili ve yan etki potansiyelinin daha az olduğu tespit edilmiştir.

Anahtar Kelimeler:

Akne vulgaris, Tretinoin, Anti-enflamatuvar ajanlar, steroid olmayan, Dermatolojik ajanlar, İlaç uygulama programı, İlaç tedavisi

Comparison of clinical efficacy of tretinoin 0.025% gel and adapalene 0.1% gel in the treatment of acute vulgaris

Adapalene is a new naphthoic acid derivative with retinoid-like activity. In this trial, we aimed to compare clinical efficacy and side effects of tretinoin 0.025% gel and adapalene 0.1% gel in the topical treatment of acne vulgaris. Forty patients with comedonal and mild inflammatory acne vulgaris were divided randomly in to two equal groups. Tretinoin 0.025% gel and adapalene 0.1% gel were applied to the first and second group, respectively. At the end of the 12th week patients were compared for the number of lesions and side effects. Whereas both agents reduced the numbers of open comedones, papules and pustules equally, we have found adapalene to be more efficacious in reducing the numbers of closed comedones and total lesions (54% vs. 70%). Side effects were lower and tolerability of the drug was better in adapalene group. As a result, adapalene 0.1% gel was more effective and well tolerated than tretinoin 0.025% gel in the treatment of acne vulgaris.

Keywords:

Acne Vulgaris, Tretinoin, Anti-Inflammatory Agents, Non-Steroidal, Dermatologic Agents, Drug Administration Schedule, Drug Therapy,

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1. Strauss JS, Thiboutot DM. Diseases of the sebaceous glands. In: Fitzpatrik TB, Freedberg IM, Wolff K, et al (eds.) Dermatolgy in General Medicine (5th ed.). Vol. 1. New York, Mc Graw-Hill Co, 1999; 769-784. 2. Tolman EL. Acne and acneiform dermatoses. In: Moshella SL, and Hurley HJ (eds.) Dermatology (3th ed). Vol 2. Philedelphia, W.B. Sounders Company, 1992; 1477-1492. 3. Arnold HL, Odom RB, James WD. Andrew's Diseases of the Skin. 4th ed. Philadelphia, London. W.B. Sounders Company, 1990; 250-267. 4. Leyden JJ. Topical treatment of acne vulgaris: Retinoids and cutaneous irritation. J Am Acad Dermatol 1998: 38 (suppl.): 1-4. 5. Erdi H. Aknede retinoid tedavisi. Memişoğlu HR, Acar MA, Aksungur ve arkadaşları (ed.) "2. Çukurova Dermatoloji GünlerTnde, 1. baskı. Adana, Çukurova Üniversitesi Basımevi, 1998; 53-60. 6. Weiss SJ, Shovin SJ. Adapalene for the treatment of acne vulgaris. J Am Acad Dermatol 1998; 39: 50-54. 7. Ellis CN, Millikan LE, Smith EB, et al. Comparison of adapalene 0.1% solution and tretinoin 0.025% gel in the topical treatment of acne vulgaris. Br J Dermatol 1998; 139 (suppl. 52): 41-47. 8. Thibooutot DM. Acne an overview of cilinical research findings. Dermatol Clin 1997; Vol 15: 1: 97-109. 9. Shroot B, Michel S. Pharmacology and chemistry of adapalene. J Am Acad Dermatol 1997; 36: 96-103.

10. Russell JJ. Topical therapy for acne. Am Fam Physician 2000; 61: 357-366. 11. Alirezai M. Meynadier J. Jablonska S, et al. Efficacy and safety comparison study of 0.1% and 0.03% adapalene gels and 0.025% tretinoin gel in the topikal treatment of acne. Ann Dermatol Venereol 1996; 123: 165-170. 12. Cunliffe WJ, Capuho R, Dreno B, et al. Efficacy and safety comparison of adapalene (CD 271) gei and tretinoin gel in the topical treatment of acne vulgaris. A European multicentre trial. J Dermatol Treat 1997; 8: 173-178. 13. Grosshans E, Marks R, Mascaro JM, et al. Evaluation of clinical efficacy and safety of adapalene 0.1% gel versus tretinoin 0.025% gel in the treatment of acne vulgaris, with particular referance to the onset of action and impact on quality of life. Br J Dermatol 1998; 139 (suppl. 52): 26-33. 14. Cunliffe WJ, Capuho R, Dreno B, et al. Clinical efficacy and safety comparison of adapalene gel and tretinoin gel in the topical treatment of acne vulgaris. Europe and US multicenter trials. J Am Acad Dermatol 1997; 36: 126-134. 15. Shalita A, Weiss JS, Chalker DK, et al. A comparison of the efficacy and safety of adapalene gel 0.1% and tretinoin gel 0.025% in the treatment of acne vulgaris: A multicenter trial. J Am Acad Dermatol 1996; 34: 482-485. 16. Galvin SA, Gilbert R, Baker M, et al. Comparitive tolerance of adapalene 0.1 %gel and six different tretinoin formulations. Br J Dermatol 1998; 139 (suppl. 52): 34-40. 17. Verschoore M, Poncet M, Czernielewski J, et al. Adapalene 0.1% gel has low skin irritation potential. J Am Acad Dermatol 1997; 36: 104-109. 18. Caron D, Sorba V, Kerrouche N et al. Split-face comparision of adapalene 0.1% gel and tretinoin 0.025% gel in acne patients. J Am Acad Dermatol 1997; 36: 110-112. 19. Clucas A, Verschoore M, Sorba V et al. Adapalene 0.1% gel better tolerated than tretinoin 0.025% gel in acne patients. J Am Acad Dermatol 1997; 36: 116-118. 20. Caron D, Sorba V, Clucas A et al. Skin tolerance of adapalene 0.1% gel in combination with other topical antiacne treatments. J Am Acad Dermatol 1997; 36: 113-115. 21. Peck GL, DiGiovanna JJ. The retinoids. In: Fitzpatrik TB, Freedberg IM, Wolff K, et al (eds.) Dermatolgy in General Medicine (4th ed.). Vol. 2. New York, Mc Graw-Hill Co, 1993; 2883-2908. 22. Kong S, Voorhees JJ. Topical Retinoids. In: Fitzpatrik TB, Freedberg IM, Wolff K, et al (eds.) Dermatology in General Medicine (5th ed). Vol. 2. New York, Mc Graw-Hill Co, 1999; 2726-2733. 23. Shroot B. Pharmacodynamics and pharmacokinetics of topical adapalene. J Am Acad Dermatol 1998; 39: 17-24. 24. Michel S, Jomard A, Demarchez M. Pharmacology of adapalene. Br J Dermatol 1998; 139 (suppl.52): 3-7.