Impact Of Body Mass Index (Bmi) On Efficacy Of Three Topical Acne Treatments In Patients With Moderate-To-Severe Acne

Acne prevalence may be higher in overweight/obese individuals, potentially due to hormonal, inflammatory, and/or dietary factors. However, BMI effect on topical acne treatments is largely unknown. This post hoc analysis investigated BMI impact on efficacy of clindamycin/benzoyl peroxide 1.2%/3.75% gel (C/BPO), tretinoin 0.05% lotion (polymeric emulsion), and tazarotene 0.045% lotion (polymeric emulsion) using data from 5 phase 3, double-blind studies. Participants with moderate-to-severe acne (Evaluator’s Global Severity Score 3 or 4) were randomized 1:1 to once-daily drug or vehicle for 12 weeks. Data were analyzed by BMI subgroup: <25 kg/m2 (underweight-to-normal), 25-<30 kg/m2 (overweight), and ≥30 kg/m2 (obese). A total of 495, 1636, and 1612 participants were included in C/BPO, tretinoin, and tazarotene analyses, respectively. In all active-treatment groups, inflammatory lesions were reduced by over 50% at week 12, regardless of BMI (range of least-squares mean percent change from baseline: C/BPO, -56.0% to -63.2%; tretinoin, -53.1% to 57.6%; tazarotene, -56.8% to -59.9%). Similar improvements in noninflammatory lesions were observed regardless of BMI, with reductions ranging from -44.9% to 56.7% across all 3 products. For vehicle-treated participants, formulation type may have affected responses; greater lesion reductions were observed with polymeric-emulsion lotion vehicles vs gel vehicle and improvements with both polymeric-emulsion vehicles were greatest in obese participants. In summary, BMI did not affect treatment outcomes with 3 topical acne medications (C/BPO 1.2%/3.75% gel, tretinoin 0.05% lotion, tazarotene 0.045% lotion); results are notable given the limited clinical data on BMI and potential impacts on the efficacy of acne treatments.