Comparative efficacy of clindamycin phosphate with benzoyl peroxide versus clindamycin phosphate with adapalene in acne vulgaris: a systematic review and meta-analysis

Sci Rep. 2025 Jul 1;15(1):20478. doi: 10.1038/s41598-025-05543-7.

Abstract

Acne vulgaris is a common skin condition that significantly impacts both physical appearance and mental well-being. Acne, being a chronic skin condition, often requires continuous treatment. This study aims to evaluate the efficacy and safety of clindamycin phosphate 1.2%/benzoyl peroxide 3% compared to clindamycin phosphate 1.2%/adapalene 0.1% combinations for treating acne vulgaris. A systematic review and meta-analysis of randomized controlled trials were carried out following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, and three databases were searched to identify RCTs comparing CLIN/BPO with CLIN/ADAP. Primary outcomes included treatment-emergent adverse events, inflammatory and non-inflammatory lesion counts, and application site side effects. Statistical analyses were conducted using RevMan 5.3. The study included a total of 800 participants across three RCTs. The meta-analysis of three RCTs demonstrated a significantly lower risk of TEAEs with CLIN/BPO (OR = 0.49, 95% CI: 0.35-0.86, p < 0.001). CLIN/BPO also resulted in fewer application site side effects (OR = 0.33, 95% CI: 0.23-0.47, p < 0.001). However, no significant differences were observed between the groups for reducing inflammatory (MD = 1.34, 𝑝 = 0.121) or non-inflammatory lesion counts (MD = 0.04, 𝑝 = 0.98). The study concluded that although CLIN/BPO was associated with fewer side effects, both treatments were equally effective in reducing acne lesions. The favorable safety profile of CLIN/BPO, particularly regarding treatment-emergent and application-site adverse events, suggests it may be the more tolerable option for patients. Future studies with larger, more diverse populations are recommended to confirm these findings and explore long-term efficacy.

Keywords: Acne vulgaris; Benzoyl peroxide; Clindamycin phosphate; Efficacy; Meta-analysis.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Comparative Study

MeSH terms

  • Acne Vulgaris* / drug therapy
  • Adapalene* / administration & dosage
  • Adapalene* / adverse effects
  • Adapalene* / therapeutic use
  • Anti-Bacterial Agents* / therapeutic use
  • Benzoyl Peroxide* / administration & dosage
  • Benzoyl Peroxide* / adverse effects
  • Benzoyl Peroxide* / therapeutic use
  • Clindamycin* / administration & dosage
  • Clindamycin* / adverse effects
  • Clindamycin* / analogs & derivatives
  • Clindamycin* / therapeutic use
  • Dermatologic Agents* / adverse effects
  • Dermatologic Agents* / therapeutic use
  • Drug Combinations
  • Humans
  • Randomized Controlled Trials as Topic
  • Treatment Outcome

Substances

  • Clindamycin
  • Benzoyl Peroxide
  • clindamycin phosphate
  • Adapalene
  • Dermatologic Agents
  • Drug Combinations
  • Anti-Bacterial Agents