Modified PDT on par with isotretinoin therapy for moderate-to-severe acne vulgaris

The modified red light 5-aminolevulinic acid photodynamic therapy (M-PDT) delivers a faster onset of improvement, similar overall efficacy, good tolerability, and comparable durability of response when compared with low-dose isotretinoin (ISO) therapy in patients with moderate-to-severe acne vulgaris, reports a study.

This multicentre, randomized clinical trial was conducted to assess the efficacy and adverse effects of M-PDT and ISO for moderate-to-severe acne vulgaris. The investigators randomly assigned 152 patients either to M-PDT (up to 5 weekly sessions following manual comedone extraction) or ISO (oral ISO 0.5 mg/kg/d for 6 months) and followed up to 6 months after therapy.

At 1 month, the overall effective rates were significantly higher with M-PDT than with ISO (67.74 percent vs 10.26 percent), but a considerable exchange occurred 1 month after treatment (75.81 percent vs 97.44 percent). In addition, time to achieve 50-percent lesion improvement was significantly less with M-PDT than with ISO (1 week vs 8 weeks).

In terms of safety, 70.67 percent of patients in the ISO group reported systemic adverse effects such as hepatotoxicity, while side effects in the M-PDT group were skin-limited.

Of note, the relatively low numbers of participants and high withdrawal rate limited this study, according to the investigators.

“M-PDT and ISO are effective treatments for moderate-to-severe acne vulgaris,” they noted.