Desloratadine addition to isotretinoin regimen reduces pruritus in acne and improves patient satisfaction: AIIMS research

The study assessed outcomes in 75 patients with moderate to severe acne undergoing treatment with either low-dose oral isotretinoin plus desloratadine or isotretinoin alone. The researchers reported that both groups showed comparable improvements in acne severity at 12 weeks, however, the patients receiving low-dose isotretinoin with desloratadine 5 mg/day reported significantly lower pruritus rates and higher rates of satisfaction with treatment.

Neirita Hazarika, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India, and colleagues aimed to measure the effectiveness of oral isotretinoin with desloratadine versus oral isotretinoin alone in moderate to severe acne treatment at a tertiary care teaching hospital in North India.

The researchers enrolled 90 patients with moderate to severe acne to participate based on their fulfilling inclusion criteria in a randomized, assessor-blinded, parallel-arm study.

Using computer-generated tables, randomization was done to allocate treatments in a 1:1 ratio. A low-dose oral isotretinoin at 0.3 mg/kg/day with tab desloratadine at 5 mg/day was applied to the study group and compared with the same patients going without dosage when controls were conducted. The patients were followed up at 4, 8, and 12 weeks.

Following were the study’s key findings:

• The primary outcome was an improved global acne grading system (GAGS) score and decreased acne lesion count.
• Secondary outcome: patient satisfaction with treatment. The 90 participants were randomized and 15 participants dropped out of the study, leaving 75 participants for intention to treat analysis (n = 41, n = 30).
• At week 12, the GAGS score and acne lesion count between the study and control groups were comparable.
• Pruritus reported was 9.76% in the study versus 33.33% in the control group.
• 53.66% of participants reported “excellent” treatment satisfaction in the study group versus 36.67% in the control group.

"In patients experiencing pruritus related to isotretinoin therapy, the addition of treatment with desloratadine, or alternative oral antihistamines, may increase compliance and patient satisfaction," the researchers wrote.

Reference:

Hazarika, N., Yadav, P., Bagri, M., Chandrasekaran, D., & Bhatia, R. Oral isotretinoin with desloratadine compared with oral isotretinoin alone in the treatment of moderate to severe acne: A randomized, assessor-blinded study. International Journal of Dermatology. https://doi.org/10.1111/ijd.17129