Comparison of the Efficacy of Clascoterone, Trifarotene, and Tazarotene for the Treatment of Acne: A Systematic Literature Review and Meta-Analysis

Mahek Shergill; Muhammad Usman Ali; Mohannad Abu-Hilal

doi:10.1007/s13555-024-01175-3

Comparison of the Efficacy of Clascoterone, Trifarotene, and Tazarotene for the Treatment of Acne: A Systematic Literature Review and Meta-Analysis

Dermatol Ther (Heidelb). 2024 May;14(5):1093-1102. doi: 10.1007/s13555-024-01175-3. Epub 2024 May 11.

Authors

Mahek Shergill¹, Muhammad Usman Ali², Mohannad Abu-Hilal^{3

4}

Affiliations

¹ Michael G. DeGroote School of Medicine, McMaster University, 100 Main Street West, Hamilton, ON, L8P 1H6, Canada.
² Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada.
³ Michael G. DeGroote School of Medicine, McMaster University, 100 Main Street West, Hamilton, ON, L8P 1H6, Canada. Abuhilm@mcmaster.ca.
⁴ Division of Dermatology, McMaster University, Hamilton, ON, Canada. Abuhilm@mcmaster.ca.

Abstract

Introduction: Acne vulgaris, a chronic inflammatory condition, is associated with significant physical and psychosocial burden. Since 2019, three new topical agents for acne vulgaris have been approved in the USA and Canada. We performed a systematic review and meta-analysis to compare the efficacy between twice-daily clascoterone cream 1%, once-daily trifarotene 0.005% cream, and once-daily tazarotene 0.045% lotion for acne treatment.

Methods: Randomized controlled trials (RCTs) comparing clascoterone, trifarotene, or tazarotene with vehicle in patients with moderate-to-severe acne were identified from a systematic literature review and included in a meta-analysis. Primary outcomes were percentage reduction in inflammatory and noninflammatory lesion count (ILC and NILC, respectively) and treatment success rate (≥ 2-grade improvement in Investigator's Global Assessment or Evaluator's Global Severity Score and a rating of clear or almost clear) at week 12. DerSimonian and Laird random-effects models with the inverse variance method were used to calculate the mean difference (MD) for percentage reduction in ILC and NILC, and odds ratios (ORs) for the rate of treatment success.

Results: Six Phase 3 RCTs were included in the meta-analysis. The analyses showed robust differences favoring the interventions for ILC (MD: - 11.5; 95% confidence interval [CI]: - 14.39, - 8.62), NILC (MD: - 12.25; 95% CI: - 15.21, - 9.29), and treatment success rate (OR: 2.14; 95% CI: 1.81, 2.53). No differences were observed between clascoterone, trifarotene, and tazarotene for ILC (MD: - 12.8, - 11.2, and - 10.1, respectively), NILC (MD: - 11.6, - 13.9, and - 12.8, respectively), or treatment success rate (OR: 2.9, 1.9, and 2.1, respectively (all P > 0.05).

Conclusion: No significant differences in efficacy were observed between clascoterone, trifarotene, and tazarotene after 12 weeks of treatment in patients with moderate-to-severe acne. Differences in application frequency and safety profile should also be taken into consideration when making treatment decisions.

Keywords: Acne vulgaris; Clascoterone; Efficacy; Meta-analysis; Retinoids; Therapy; Topical.

Publication types

Review