Efficacy and tolerability of three topical acne treatments by body mass index: post hoc analysis including overweight and obese patients

Background: Acne prevalence may be higher in overweight/obese individuals, potentially due to hormonal, inflammatory, and/or dietary factors. However, the effects of body mass index (BMI) on topical acne treatments are largely unknown. Methods: Post hoc analyses of changes in inflammatory/noninflammatory lesions and treatment success were conducted using phase 3 data: clindamycin phosphate/benzoyl peroxide (CP/BPO) 1.2%/3.75% gel (NCT01701024); tretinoin 0.05% lotion (NCT02965456 and NCT02932306; pooled); and tazarotene 0.045% lotion (NCT03168321 and NCT03168334; pooled). Data were analyzed by BMI subgroups: <25kg/m² (underweight-to-normal), 25-<30kg/m² (overweight), and ≥30kg/m² (obese). Results: Among participants analyzed (CP/BPO = 495; tretinoin = 1,636; tazarotene = 1,612), ∼20–25% were overweight and 15–20% were obese. At week 12, mean percent changes from baseline in inflammatory lesions were: CP/BPO (overweight: −63.2%, obese: −56.0%); tretinoin (−57.6%, −53.1%); tazarotene (−59.9%, −56.8%). Mean changes in noninflammatory lesions were: CP/BPO (−54.2%, −50.8%); tretinoin (−51.6%, −44.9%); tazarotene (−56.7%, −54.6%). Treatment success rates with active treatment ranged from 16.2% to 33.5% across BMI groups. Conclusions: CP/BPO 1.2%/3.75% gel, tretinoin 0.05% lotion, and tazarotene 0.045% lotion were all effective in reducing acne lesions by ≥45% in overweight/obese patients with moderate-to-severe acne, comparable to the underweight-to-normal group. Efficacy of these topical acne treatments is not greatly impacted by BMI and may be affected more by the formulation.