Kommersiellt obunden läkemedelsinformation riktad till läkare och sjukvårdspersonal

Bensoylperoxid

Klassificering: B

Preparat: Basiron® AC, Basiron® AC Wash, Brevoxyl, Duac®, Epiduo, Stioxyl

ATC kod: D10AD53, D10AE01, D10AF51

Substanser: bensoylperoxid

Sammanfattning

Det saknas studier med relevant könsanalys på bara bensoylperoxid. I post hoc analyser av kombinationsbehandling av gel med bensoylperoxid samt klindamycin har likvärdig tolerabilitet hos båda könen men bättre effekt på acne påvisats hos kvinnor/flickor, framförallt under tonåren.
 
Kunskapsunderlaget avseende skillnader mellan kvinnor och män är begränsat och motiverar inte olika dosering eller behandling.

Additional information

Pharmacokinetics and dosing

No studies with a clinically relevant sex analysis regarding pharmacokinetics or dosing of bensoyl peroxide have been found. Transdermal absorption seems to be similar in men and women [6].

Effects

The efficacy of clindamycin phosphate 1.2%/ bensoyl peroxide 3.75% gel was found to be greater than vehicle in both men and women but with a more pronounced effect in women [7].In a post hoc analysis (including 797 men and women) of two studies evaluating efficacy and tolerability of clindamycin phosphate 1.2%/ bensoyl peroxide 2.5% gel (in all 2813 persons included) adolescent girls had better effect than adolescent boys [8].

Adverse effects

In the post hoc analysis mentioned above, bensoyl peroxide tolerability was reported to be comparable in males and females [8].A retrospective study of patch tests (12 087 men, 17 671 women) found positive reactions to be rather common (7.8%). Logistic regression showed female sex to be one of the factors associated with a higher risk of a strong positive reaction. However, the authors caution that as sensitization to the substance is rare, a positive patch test for bensoyl peroxide has unclear significance and needs to be assessed carefully [9].

Reproductive health issues

Regarding teratogenic aspects, please consult the Drugs and Birth Defects Database (in Swedish, Janusmed fosterpåverkan).

Other information

Acne is very common in teenagers, affecting 80-90% to some degree [1]. In a study of volunteers above the age of 25 years (322 men, 427 women) clinical facial acne was recorded in 3% and 12% of men and women, respectively [2].

A prospective study of quality of life and choice of therapy in acne (143 females, 68 males) found the quality of life to improve after treatment at a group level. Women had a lower quality of life score not correlated to severity of acne at start of the study. After six months of treatment with acne preparations the quality of life score correlated to clinical grading and also to treatment with isoretinoin [3].

Age and sex-matched acne patients (270 men, 270 women) with a mean age of 20 years had their skin pH measured, showing the pH of the female face to be slightly higher than that of the male one. Skin pH is affected by age, anatomical site, genetic factors, sebum, skin moisture, sweat, detergents, cosmetics, soaps, washing patterns, and occlusive dressing [4].

Healthy volunteers (30 men, 30 women) were studied to determined influencing factors for facial pores. Factors increasing pores were male sex, increased sebum and decreased skin elasticity [5].In a drug utilization study from the US prescription of acne treatments were followed from 1990 to 2002. Bensoyl peroxide prescriptions were equally common in male and female patients and declined over the time studied in a similar way [10].

Försäljning på recept

Läkemedel innehållande endast bensoylperoxid (ATC-kod D10AE01) köps huvudsakligen receptfritt och därför saknas könsspecifika användningsdata [11].

Fler kvinnor än män hämtade ut gel innehållande klindamycin i kombination med tretinoin eller bensoylperoxid (ATC-kod D10AF51) på recept i Sverige år 2015, totalt 11 551 kvinnor och 6 014 män. Det motsvarar 2,4 respektive 1,2 patienter per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 15-19 år hos båda könen. I genomsnitt var gel innehållande klindamycin i kombination med tretinoin eller bensoylperoxid 2,7 gånger vanligare hos kvinnor [12].

Fler kvinnor än män hämtade ut läkemedel innehållande kombination av bensoylperoxid och adapalen (ATC-kod D10AD53) på recept i Sverige år 2015, totalt 13 093 kvinnor och 8 212 män. Det motsvarar 2,7 respektive 1,7 personer per tusen invånare. Andelen som hämtat ut läkemedel var högst i åldersgruppen 15-19 år hos båda könen. I genomsnitt var läkemedel innehållande kombination av bensoylperoxid och adapalen 1,6 gånger vanligare hos kvinnor [12].

Uppdaterat: 2019-02-26

Litteratursökningsdatum: 2016-06-15

Referenser

  1. Lello J, Pearl A, Arroll B, Yallop J, Birchall NM. Prevalence of acne vulgaris in Auckland senior high school students. N Z Med J. 1995;108:287-9. PubMed
  2. Goulden V, Stables GI, Cunliffe WJ. Prevalence of facial acne in adults. J Am Acad Dermatol. 1999;41:577-80. PubMed
  3. Berg M, Lindberg M. Possible gender differences in the quality of life and choice of therapy in acne. J Eur Acad Dermatol Venereol. 2011;25:969-72. PubMed
  4. Youn SH, Choi CW, Choi JW, Youn SW. The skin surface pH and its different influence on the development of acne lesion according to gender and age. Skin Res Technol. 2013;19:131-6. PubMed
  5. Kim BY, Choi JW, Park KC, Youn SW. Sebum, acne, skin elasticity, and gender difference - which is the major influencing factor for facial pores?. Skin Res Technol. 2013;19:e45-53. PubMed
  6. Harper JC. The efficacy and tolerability of a fixed combination clindamycin (12%) and benzoyl peroxide (375%) aqueous gel in patients with facial acne vulgaris: gender as a clinically relevant outcome variable. J Drugs Dermatol. 2015;14:381-4. PubMed
  7. Harper JC. Gender as a clinically relevant outcome variable in acne: benefits of a fixed combination clindamycin phosphate (12%) and benzoyl peroxide (25%) aqueous gel. J Drugs Dermatol. 2012;11:1440-5. PubMed
  8. Ockenfels HM, Uter W, Lessmann H, Schnuch A, Geier J. Patch testing with benzoyl peroxide: reaction profile and interpretation of positive patch test reactions. Contact Dermatitis. 2009;61:209-16. PubMed
  9. Thevarajah S, Balkrishnan R, Camacho FT, Feldman SR, Fleischer AB. Trends in prescription of acne medication in the US: shift from antibiotic to non-antibiotic treatment. J Dermatolog Treat. 2005;16:224-8. PubMed
  10. Conicse. Stockholm: eHälsomyndigheten. 2015 [cited 2016-03-23.] länk
  11. Läkemedelsstatistik. Stockholm: Socialstyrelsen. 2015 [cited 2016-06-30.] Socialstyrelsens statistikdatabas

Författare: Mia von Euler, Linnéa Karlsson Lind

Faktagranskat av: Mia von Euler

Godkänt av: Karin Schenck-Gustafsson