INTRODUCTION
Acne vulgaris is a common inflammatory skin condition that affects approximately 85% of teenagers at some point in their lives and up to 20% may develop facial scarring.1,2 Although acne primarily affects younger individuals, acne can persist into adulthood and can affect any age group. Acne can lead to severe scarring and psychological distress leading to lower self-esteem, anxiety, and depression.3 There are many different treatments for acne and many providers will choose a treatment regimen based on the clinical type (comedonal, papulopustular, mixed, or nodular) and severity.1
There are many different scales for grading acne severity. FDA recommends grading acne via an IGA scale. The different grades include clear (grade 0), almost clear (grade 1), mild severity (grade 2), moderate severity (grade 3), and severe (grade 4).4 The FDA suggests assessing treatment as either success or failure, with success defined as clear (grade 0) or almost clear (grade 1) with at least a two-grade improvement in acne severity from baseline.4
The purpose of this study is to determine the likelihood of success in patients with acne according to FDA guidance. Since first-line treatment for acne can include combination therapy, we will also determine the number of medications prescribed in acne outpatient visits.
There are many different scales for grading acne severity. FDA recommends grading acne via an IGA scale. The different grades include clear (grade 0), almost clear (grade 1), mild severity (grade 2), moderate severity (grade 3), and severe (grade 4).4 The FDA suggests assessing treatment as either success or failure, with success defined as clear (grade 0) or almost clear (grade 1) with at least a two-grade improvement in acne severity from baseline.4
The purpose of this study is to determine the likelihood of success in patients with acne according to FDA guidance. Since first-line treatment for acne can include combination therapy, we will also determine the number of medications prescribed in acne outpatient visits.
MATERIALS AND METHODS
Clear or Almost Clear Rate for Medications in Acne
In this retrospective study, we relied on the FDA highlights of prescribing information to obtain the IGA 0/1 for all of the topical medications and two of the oral medications, sarecycline and drospirenone-ethinyl estradiol. For the remaining oral medications, we searched peer-reviewed publications to obtain the clear or almost clear rate. If there were multiple studies for a medication, we calculated an appropriate weighted estimate. All of the studies identified 12 weeks, except for the isotretinoin studies, which lasted 20 weeks and the drospirenone-ethinyl estradiol studies, which lasted 24 weeks.
The FDA suggests grading acne outcomes via an IGA scale, however, a few of the studies included other scoring scales such as the Evaluator’s Global Severity (EGS) or the Global Acne Assessment Score (GAAS). For the purposes of this paper, we can assume that the other scoring scales were equivalent to the
In this retrospective study, we relied on the FDA highlights of prescribing information to obtain the IGA 0/1 for all of the topical medications and two of the oral medications, sarecycline and drospirenone-ethinyl estradiol. For the remaining oral medications, we searched peer-reviewed publications to obtain the clear or almost clear rate. If there were multiple studies for a medication, we calculated an appropriate weighted estimate. All of the studies identified 12 weeks, except for the isotretinoin studies, which lasted 20 weeks and the drospirenone-ethinyl estradiol studies, which lasted 24 weeks.
The FDA suggests grading acne outcomes via an IGA scale, however, a few of the studies included other scoring scales such as the Evaluator’s Global Severity (EGS) or the Global Acne Assessment Score (GAAS). For the purposes of this paper, we can assume that the other scoring scales were equivalent to the
