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Background In addition to physical long-lasting effects such as permanent scarring and disfigurement, acne has acute and long-term psychosocial effects that affect the individual's quality of life. As with other chronic diseases, treatment success is often compromised by poor adherence. Objective Two main objectives of this non-interventional study were to assess the long-term effect of the fixed-dose combination adapalene 0.1%/benzoyl peroxide 2.5% (adapalene- BPO gel) on quality of life and treatment adherence. Methods Patients with moderate to severe facial acne receiving adapalene- BPO alone or in combination with other drugs were enrolled in this non-interventional study. Data were documented at baseline and after 3 and 9 months of adapalene- BPO treatment. The secondary outcomes reported here include quality of life determined by the Cardiff Acne Disability Index ( CADI), treatment adherence assessed by the ECOB (Elaboration d'un outil d'evaluation de l'observance des traitements medicamenteux) questionnaire, and patient satisfaction. Results In total, 5131 patients were included in the efficacy evaluation. After 9 months, mean (± SD) quality of life ( CADI) improved significantly from 5.9 ± 3.0 to 2.4 ± 2.7 ( P < 0.0001). Patients with more severe acne at baseline tended to achieve a greater improvement in quality of life. Long-term adherence was found to be good in 83.9% of patients. Adherence had a significant effect on efficacy and quality of life ( P < 0.0001 respectively). The vast majority of patients (92.1%) reported subjective improvement at the interim analysis. Accordingly, most patients (84.8%) were satisfied or very satisfied with adapalene- BPO by the end of the observation period. Conclusion The clinical improvement of the disease led to an increase in quality of life among acne patients. The treatment success may be a motivation factor for patients to stay adherent over the long-term treatment course, indicating the qualification of adapalene- BPO topical gel as an appropriate medication also in the long-term usage. [ABSTRACT FROM AUTHOR]

Background Acne is a chronic inflammatory disease requiring long-term treatment. The fixed-dose combination adapalene 0.1%/benzoyl peroxide 2.5% (adapalene- BPO) is indicated for the once-daily topical treatment of Acne vulgaris when comedones, papules and pustules are present. Objective The main objectives of this non-interventional study were to assess long-term efficacy and safety of adapalene- BPO in moderate to severe acne with and without concomitant medication. Methods Patients with moderate to severe acne received adapalene- BPO alone or in combination with concomitant medication over a course of 9 months. The primary efficacy endpoint was changes in acne severity according to the Leeds Revised Acne Grading System; secondary endpoints included treatment success assessed by the patient and safety. Results In total, 5131 patients were eligible for efficacy and 5141 for safety evaluation. The majority of patients (78.8%) received adapalene- BPO alone. About 21.2% received adapalene- BPO in combination with another agent, mostly topical antibiotics (8.8%) or systemic antibiotics (8.7%). Mean (±SD) acne severity improved from 5.6 ± 1.5 at baseline to 3.3 ± 1.9 at month 3, and further to 1.9 ± 1.9 at month 9 (both P < 0.0001). The degree of improvement correlated significantly with the severity at baseline. After 3 and 9 months of treatment, the facial skin was cleared completely (no more visible acne lesions) in 420 (8.2%) and 1326 patients (25.8%), respectively. A therapeutic effect was noted by the patients after a median time of 3 weeks (range: from 1 day to 12 weeks). No serious adverse events were reported. Facial skin irritations, mostly mild to moderate, occurred in 49.5% of patients and led to discontinuation in only 1.7% of cases. Conclusion In consistence with previous clinical findings, the use of adapalene- BPO in daily practice routine is safe and effective in the long-term management of patients with moderate to severe acne. [ABSTRACT FROM AUTHOR]

Prostaglandins have been shown to be involved in the suppression of contact hyper sensitivity (CHS) by so-far ill understood mechanisms. T-cell migration across the lining of cytokine-activated endothelial cells (EC) is thought to be a central step in the initiation of CHS. The aim of our investigation was therefore to examine whether prostaglandin E[sub1] (PGE[sub1]) influences cytokine-induced TK-1 mouse lymphoma adhesion to eEnd.2 mouse endothelioma cells. Here, we report that PGE[sub1] (10[sup―12]10[sup―8] M) dose-dependently induced TNFα-induced T-cell binding, while TNFα-unstimulated adhesion was not affected. To test whether PGE[sub1], acted primarily on T-cells or on EC, they were separately pretreated with PGE[sub1] prior to the adhesion assay. Selective PGE[sub1] pretreatment of eEnd.2, but not of TK-1 dose-dependently inhibited TN Fα, stimulated T-cell adhesion. Since binding of TK-1 to TNFα-treated eEnd.2 is mediated by the interaction of ICAM-1 and VCAM-1 (on EC) with their receptors LFA-1 and VLA-4 (on T-ceIIs), we further investigated whether PGE[sub1] would modulate the expression of these molecules FACS-analysis revealed PGE[sub1] to inhibit TNFα-induced upregulation of ICAM-1, but not of VCAM-1 on EC. Furthermore, constitutive LFA-1 and VLA-4 expression on T-cells was not affected by PGE[sub1]. We conclude that PGE[sub1] supresses T-cell adhesion to EC by selectively inhibiting TNFα-induced upregulation of ICAM-1 on EC. This may be one mechanism by which prostaglandins suppress immune responses requiring T-cell EC interactions such as contact hypersensitivity in skin. [ABSTRACT FROM AUTHOR]