A EFFICACY COMPARISON OF ISOTRETINOIN AND ISOTRETINOIN MINOCYCLINE-ER IN MODERATE TO SEVERE ACNE
*Dr. Asma Fatima (Pharm.D), Dr. Faiz Unnisa Begum and Dr. Ayesha Butool
ABSTRACT
Background: The purpose of the study is to update the latest developments related to economic evaluation of acne vulgaris and further to present a reference model for the assessment of the efficacy and treatment of moderate to severe acne vulgaris. Methods: A prospective observational comparative study. In our study we divided 120 acne patients into two groups (Group A and Group B) each containing 60 patients. Group A was prescribed with the combination Isotretinoin + Clindamycin & Group B Minocycline + Clindamycin. Follow ups are planned 1st week after initiation of therapy, then every two weeks. Clinical assessment was made based on two different parameters cumulative reduction in grades and lesion score. Result: A total number of 120 patients were taken into the study and assessed for
cost effectiveness. These 120 patients were divided into 2 groups i.e.; Group A (Isotretinoin + Clindamycin) and Group B (Minocycline+ Clindamycin), each group consisting of 60 patients. Different parametric and non parametric tests were applied for statistical evaluation. Paired T- Test was performed to determine the significance of lesion score and t value for group A and group B was found to be 35.953 and 36.117 respectively at 95% confidence interval. Wilcoxon sign rank test was performed to determine the significance of grade score. In both groups, treatment was found to be highly significant in the outcome when compared to baseline. Univariate analysis of covariance (ANCOVA) was performed to compare the efficacy of both the drugs, in relation to lesion score. The actual mean of isotretinoin and minocycline was found to be 2.13 and 3.46 respectively. Ordinal regression test was performed to compare the efficacy of both the treated groups in relation to grade score. It is expressed in the form of marginal percentage. Goodness of fit and Pseudo R square tests were performed. The test was found to be significant. At threshold, 95% confidence interval lower bound was 0.841 and upper bound was found to be 10.561. Compared to Group B, Group A has shown more efficacy and it is also statistically significant. Conclusion: It was concluded that Group A (Isotretinoin+ Clindamycin) combination showed to be more efficaceous than Group B (Minocycline+ Clindamycin) based on the clinical and statistical evaluation.
Keywords: Efficacy, Acne Vulgaris, Patient Counseling, Isotretinoin, Minocycline, Clindamycin.
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