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Comparative Study
. 2024 May 30;19(5):e0298155.
doi: 10.1371/journal.pone.0298155. eCollection 2024.

The efficacy of Topical Clascoterone versus systematic spironolactone for treatment of acne vulgaris: A systematic review and network meta-analysis

Mohammad A Basendwh  1 , Amer Abdulaziz Alharbi  2 , Sarah Abdulla Bukhamsin  3 , Rahaf Abdulrashid Abdulwahab  4 , Sarah Abdullah Alaboud  4
Affiliations
Comparative Study

The efficacy of Topical Clascoterone versus systematic spironolactone for treatment of acne vulgaris: A systematic review and network meta-analysis

Mohammad A Basendwh et al. PLoS One. .

Abstract

Objectives: This study aimed to evaluate the effectiveness of topical clascoterone (TC) compared to oral spironolactone for acne vulgaris treatment.

Methods: A computerized search through PubMed/MEDLINE, SCOPUS, and the Cochrane Library was conducted to find relevant papers. We used the "netmeta" and "meta" packages for network meta-analysis (NMA) in RStudio 1.2.5019 (2009-2019 RStudio, Inc.) to conduct all of our statistical tests.

Results: Seven articles (n = 2,006 patients) were included. The fixed-effect size showed that TC 1% bis in die (BID) showed potential effectiveness in reducing the inflammatory and non-inflammatory lesion count compared to placebo (Standardized mean difference, SMD = -0.27, 95% CI: -0.36 to -0.17) and (SMD = -0.31, 95% CI: -0.41 to -0.22), respectively. The random-effect size showed that TC 1% BID was significantly associated with a 12-week treatment success compared to placebo (Odds ratio, OR = 2.44, 95% CI: 1.12 to 5.30). Spironolactone 200 mg was associated with a significant reduction in total lesion count (SMD = -4.46, 95% CI: -5.60 to -3.32).

Conclusion: TC appears to reduce both inflammatory and non-inflammatory lesion count and may lead to treatment success. Spironolactone at 200 mg showed potential effectiveness in terms of total lesion count reduction. These results suggest that both TC and Spironolactone could be beneficial in treating patients with acne vulgaris.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram.
Fig 2
Fig 2. Quality assessment of included studies.
Fig 3
Fig 3. Network graph.
A) NILC; B) TLC; C) ILC; D) IGA; Bold lines between studied arms means reflect the number of studies; the bolder the line the larger the number of studies.
Fig 4
Fig 4
Forest Plot of A) NILC; B) TLC; C) ILC; D) IGA.
Fig 5
Fig 5. Rankogram of IGA interventions.
See this image and copyright information in PMC

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