A comparison of adapalene gel 0.1% vs. tretinoin gel 0.025% in the treatment of acne vulgaris in China

ABSTRACT Aim To compare the efficacy, safety and tolerability of adapalene gel 0.1% vs. tretinoin gel 0.025% in a Chinese patient population. Background Although acne vulgaris is a common problem among Asians and Asian‐Americans, little has been published on the specific manifestations, sequelae, and treatment‐responsiveness of this disorder in Asian skin types. Since Asian skin types tend to be more highly pigmented than those of white people of European descent, many Asians share the predisposition toward postinflammatory hyperpigmentation seen in Africans, African‐Americans and other dark‐skinned peoples. It is generally assumed that the efficacy and safety of topical retinoids is the same in Asians as in white people. Tretinoin has been available in China for decades; adapalene became available in 1998. Methods A total of 150 patients with grade II–III acne vulgaris seen at three dermatology clinics were randomized to 8 weeks of daily treatment with either adapalene gel 0.1% or tretinoin gel 0.025%. Counts of total lesions, inflammatory lesions and non‐inflammatory lesions were made at baseline and again at treatment weeks 2, 4, 6 and 8. Global assessment ratings, based on percent lesion reduction from baseline were also made. Erythema, burning, pruritus, scaling and dryness were rated on a 0–3 severity scale. Results A total of 139 patients completed the efficacy evaluation, and 144 patients completed the safety evaluation. Both adapalene and tretinoin produce dramatic reductions in total, inflammatory and non‐inflammatory lesion counts, in the range of 69–74% on average. More than 70% of patients in both groups had complete clearance or marked improvement. In general, irritation was mild, but was both more common and more severe in the tretinoin group vs. the adapalene group. No systemic side effects were seen. Conclusions Adapalene offers comparable efficacy to tretinoin, but is less irritating. It represents a good alternative for the treatment of mild to moderate acne vulgaris in Chinese patients.