The results of the trial showed that a branded tretinoin Cream with a polymeric emulsion-based carrier was superior to a generic tretinoin cream in a variety of acne outcomes.
A barrier-enhancing polymeric emulsion-based vehicle was used in the branded tretinoin Cream that was the subject of the study, according to Zoe Diana Draelos, MD, of Dermatology Consulting Services, PLLC, who spoke with Healio. Retinoid dermatitis can be brought on by tretinoin because it is a retinoid. Patients who are prescribed buy tretinoin cream for therapy face a compliance barrier in the form of this retinoid dermatitis.
According to Draelos, the polymeric emulsion can overcome this compliance barrier since it has a greater barrier function and causes less discomfort.
The unique, cutting-edge vehicle, according to her, “improves patient compliance and satisfaction with treatment.” “The skin barrier is harmed by generic tretinoin.” Understanding the benefits of a polymer emulsion vehicle for retinoid administration was the goal of this study.
Draelos and colleagues examined 25 adult women with acne and compared the branded tretinoin 0.05% Cream (Altreno, Ortho Dermatologics) with the generic version in a single-center, double-blind, split-face study. The generic version was not sticky or left behind little residue. Only 8–36% of participants thought these qualities were superior in the generic product, in contrast.
The branded product also performed better in terms of skin softness, dryness, and dullness (> 60% agreement) than the generic (40% agreement).
Approximately 70% of patients said they preferred the branded product to the generic overall.
Draelos and his associates were 38–41% surprised by these results.
The findings from the investigator and blinded subjects were unexpected, according to Draelos. “In dermatology, we firmly believe that drug tolerability is determined by the skin properties of the medicine.” In this study, we showed that a well-designed contemporary vehicle can reduce drug irritability and increase patient acceptance.
Given these results, Draelos speculates that it may be true that retinoid dermatitis can be made worse by a subpar generic vehicle and made better by a polymeric emulsion-branded vehicle.
These results show that the severity of retinoid dermatitis can be reduced by combining tretinoin with a polymeric emulsion, she added. This enhances patient compliance and toleration, which leads to a better clinical outcome.
A randomized clinical trial’s findings revealed no discernible difference in effectiveness between topical tretinoin precursors and tretinoin 0.02% therapy.
According to Anna L. Chien, MD, of the dermatology department at The Johns Hopkins School of Medicine in Baltimore, and colleagues, “Retinoids are widely accepted as the criterion standard for the topical management of photodamage, improving the fine wrinkles and dyspigmentation characteristic of photodamaged skin.” However, the associated local skin irritation, including erythema, pruritus, stinging, burning, and scaling, is one of the main barriers to their topical usage.
Although over-the-counter cosmetics containing retinol and retinyl esters may produce outcomes comparable to those of prescription-grade tretinoin, the researchers pointed out that it is still not clear which of the retinoids’ alleged side effects is responsible for the clinical efficacy of tretinoin or its forerunners.
colleagues examined the outcomes of 20 white female patients who underwent a full course of treatment to compare the effectiveness of topical tretinoin cream 0.05 precursors and tretinoin retinoic acid (RA) in the treatment of moderate to severe face photodamage.
Griffiths’s measures of photoaging at week 24 revealed no significant differences between the two treatments, according to the researchers. However, compared to the tretinoin group, RA patients displayed erythema more frequently throughout treatment (difference, -0.53; 95% CI, -0.88 to -0.17).
Chien and colleagues continued, “We next were interested in which molecular targets best correspond with improvements in photodamage.”
Patients who utilized tretinoin had Griffiths photodamage scores that were lower by week 24 compared to baseline (median difference, -1; 95% CI, -2 to 0), whereas patients in the RA group had no discernible difference.
According to the researchers’ predictions, “based on this clinical analysis, equivalent pairwise comparisons of putative biomarkers should demonstrate significant and consistent changes in mRNA expression, at least with tretinoin therapy.”
Given the drawback of a small population size, Chien and colleagues stated that further research on tretinoin use might be beneficial in bigger, more diversified cohorts where parametric approaches can be applied.
