Comparative Effectiveness Study of Spironolactone Versus Doxycycline for Acne

NCT ID: NCT04582383

Last Updated: 2025-10-21

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

350 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-03-30

Study Completion Date

2026-07-31

Brief Summary

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Acne is common illness of adolescents and young adults which is associated with substantial morbidity. While topical treatments are often sufficient for mild acne, moderate to severe acne often requires treatment with systemic medications such as oral antibiotics, hormonal therapies such spironolactone, and isotretinoin. Sebum overproduction is fundamental to the pathogenesis of acne with associated disordered keratinization and subsequent microbial colonization and inflammation resulting in the clinical manifestations of acne. Given the influence of hormones on sebum production, therapies that address these underlying hormonal factors such as spironolactone and oral contraceptive pills represent an underutilized treatment option for women with acne and could help decrease the use of long-term oral antibiotics in this patient population. The purpose of this trial is to evaluate the comparative effectiveness of spironolactone versus doxycycline hyclate (tetracycline class antibiotic) for women with acne.

Detailed Description

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Conditions

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Acne

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

175 participants will be randomized to treatment with spironolactone 100mg/day and 175 participants will be randomized to treatment with doxycycline hyclate 100mg/day.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Spironolactone

In this arm, participants will receive spironolactone 100mg/day for the entirety of the study. To maximize the generalizability of the study, participants will be allowed to continue their current topical regimen as long as no changes were made in the 4 weeks prior to randomization. No additions to their topical regimen may be made during the study period.

Group Type EXPERIMENTAL

Spironolactone

Intervention Type DRUG

Dispensation of spironolactone according to the arm description.

Doxycycline hyclate

This arm is an active-comparator arm in which participants will receive doxycycline hyclate 100mg/day for the entirety of the study. To maximize the generalizability of the study, participants will be allowed to continue their current topical regimen as long as no changes were made in the 4 weeks prior to randomization. No additions to their topical regimen may be made during the study period.

Group Type ACTIVE_COMPARATOR

Doxycycline Hyclate

Intervention Type DRUG

Dispensation of doxycycline hyclate according to the arm description.

Interventions

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Spironolactone

Dispensation of spironolactone according to the arm description.

Intervention Type DRUG

Doxycycline Hyclate

Dispensation of doxycycline hyclate according to the arm description.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Female sex assigned at birth
* Age 16-40 years old
* Acne defined as at least 10 inflammatory papules or pustules and an Investigator's Global Assessment (IGA) score of at least 2 as measured by the Comprehensive Acne Severity Scale
* Not currently pregnant or planning to become pregnant

Exclusion Criteria

* Pregnancy
* Heart disease
* Renal disease
* Liver disease
* Orthostatic hypotension
* Addison's disease
* History of hyperkalemia
* Allergy to tetracycline-class antibiotic
* Allergy to spironolactone
* Concomitant use of medications known to interact with spironolactone or doxycycline or that may increase the risk for hyperkalemia, including angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, eplerenone, nonsteroidal anti-inflammatory drugs, and digoxin.
* Treatment with spironolactone, an oral antibiotic, laser, photodynamic therapy, or chemical peel within the past 4 weeks
* Treatment with isotretinoin within the past 3 months
* Sebacia laser treatment within the past 12 months
Minimum Eligible Age

16 Years

Maximum Eligible Age

40 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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University of Pennsylvania

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Johnson Dermatology

Fort Smith, Arkansas, United States

Site Status

University of California San Francisco

San Francisco, California, United States

Site Status

Cura Clinical Research

Sherman Oaks, California, United States

Site Status

University of Miami

Miami, Florida, United States

Site Status

New Horizon Research Center

Miami, Florida, United States

Site Status

Dawes Fretzin Clinical Research Group

Indianapolis, Indiana, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

New York University

New York, New York, United States

Site Status

Northwell Health

North New Hyde Park, New York, United States

Site Status

Dermatologists of Central States

Cincinnati, Ohio, United States

Site Status

Ohio State University Medical Center

Columbus, Ohio, United States

Site Status

Cyn3rgy Research

Gresham, Oregon, United States

Site Status

Oregon Health and Science University

Portland, Oregon, United States

Site Status

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

University of Pennsylvania

Philadelphia, Pennsylvania, United States

Site Status

Arlington Research Center

Arlington, Texas, United States

Site Status

North Texas Center for Clinical Research

Frisco, Texas, United States

Site Status

CCS Texas

Houston, Texas, United States

Site Status

Countries

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United States

Other Identifiers

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R34AR074733-01A1

Identifier Type: NIH

Identifier Source: org_study_id

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