Comparison Between Isotretinoin, Silymarin and Both in the Treatment of Acne Vulgaris

NCT ID: NCT05666765

Last Updated: 2022-12-28

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

UNKNOWN

Clinical Phase

PHASE4

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-01

Study Completion Date

2024-01-01

Brief Summary

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This study aims to compare the effects of isotretinoin and silymarin or both in treatment of acne and their effects on the level of IGF-1, SAA1 and malondialdehyde (MDA) in acne patients.

Detailed Description

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Acne vulgaris, a common and chronic disorder of the pilosebaceous unit, affects up to 85% of adolescent and young adults. The pathogenesis of acne is multifactorial. Traditionally, four distinct processes were believed to play critical roles: increased sebum production, alteration of keratinization processes leading to comedone formation, follicular colonization by Propionibacterium acnes (P.acnes) and inflammatory mediators around pilosebaceous unit.

Orally administered isotretinoin is currently the only agent that can affect all four main factors implicated in acne.

Serum insulin-like growth factor -1(IGF)-1 is a polypeptide hormone that has effects on sebocyte differentiation and proliferation. It leads to lipogenesis, and synthesis of inflammatory cytokines. IGF-1 also stimulates androgen synthesis leading to overproduction of sebum.

Propionibacterium acnes can increase the release of serum amyloid A1 (SAA1) .There is significant elevation of SAA1 in patients with acne, with a positive correlation with its severity.

Oxidative stress plays a role in the pathogenesis of acne in part due to the generation of reactive oxygen species (ROS) in response to infection by the bacterium Propionibacterium acnes, which colonizes the skin and grows in plugged hair follicles, thus attracting inflammatory cells, mainly neutrophils. These in turn secrete inflammatory mediators and generate ROS, which augments the inflammatory response and tissue damage.

Silymarin, the main active component of milk thistle consists of a mixture of flavonolignans and flavonoid taxifolin. Silymarin acts as a hepatoprotective, anticancer, anti-inflammatory and immunomodulatory agent.

Silymarin acts as a free radical scavenger, stabilizes the plasma membrane and reduces the production of inflammatory mediators produced by P. acnes, and scavenges the released free radicals.

Conditions

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Acne Vulgaris

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Prospective controlled
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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acne vulgaris patients group 1

acne patients will be rondomly assigned to 1 of the 3 interventions (isotretinoin, silymarin, or both)

Group Type EXPERIMENTAL

Isotretinoin ,silymarin

Intervention Type DRUG

20mg/day isotretinoin for 3 months. 140 mg/day silymarin for 3 months. 20mg/day isotretinoin and 140mg/day silymarin for 3 months.

acne vulgaris patients group 2

acne patients will be rondomly assigned to 1 of the 3 interventions (isotretinoin, silymarin, or both)

Group Type EXPERIMENTAL

Isotretinoin ,silymarin

Intervention Type DRUG

20mg/day isotretinoin for 3 months. 140 mg/day silymarin for 3 months. 20mg/day isotretinoin and 140mg/day silymarin for 3 months.

acne vulgaris patients group 3

acne patients will be rondomly assigned to 1 of the 3 interventions (isotretinoin, silymarin, or both)

Group Type EXPERIMENTAL

Isotretinoin ,silymarin

Intervention Type DRUG

20mg/day isotretinoin for 3 months. 140 mg/day silymarin for 3 months. 20mg/day isotretinoin and 140mg/day silymarin for 3 months.

Interventions

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Isotretinoin ,silymarin

20mg/day isotretinoin for 3 months. 140 mg/day silymarin for 3 months. 20mg/day isotretinoin and 140mg/day silymarin for 3 months.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age: 16 years or more. Patient with moderate or severe acne. Not receiving acne treatment in the last month.

Exclusion Criteria

* Pregnancy or lactation. Patients with known hypersensitivity to isotretinoin or silymarin. Patients with depression, liver diseases or high cholesterol. Patients with acromegaly. Patients with chronic inflammatory, infective or neoplastic disorders.
Minimum Eligible Age

16 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Tanta University

OTHER

Sponsor Role lead

Responsible Party

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Ghada mohamed abdelmonem mohamed Tantawy

Principle investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Ghada F Hassan, A.professor

Role: STUDY_CHAIR

Tanta University

Dalia R Elafify, Doctor

Role: STUDY_CHAIR

Tanta University

Locations

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Tanta University

Tanta, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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Ghada M Tantawy, Doctor

Role: CONTACT

Phone: 00201144062267

Email: [email protected]

Sahar M El-hagger, Professor

Role: CONTACT

Phone: 0020403336007

Facility Contacts

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Dalia R Elafify, Doctor

Role: primary

References

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Hazarika N. Acne vulgaris: new evidence in pathogenesis and future modalities of treatment. J Dermatolog Treat. 2021 May;32(3):277-285. doi: 10.1080/09546634.2019.1654075. Epub 2019 Aug 29.

Reference Type BACKGROUND
PMID: 31393195 (View on PubMed)

Shie Morteza M, Hayati Z, Namazi N, Abdollahimajd F. Efficacy and safety of oral silymarin in comparison with oral doxycycline and their combination therapy in the treatment of acne vulgaris. Dermatol Ther. 2019 Nov;32(6):e13095. doi: 10.1111/dth.13095. Epub 2019 Oct 21.

Reference Type BACKGROUND
PMID: 31579978 (View on PubMed)

Other Identifiers

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Treatment of acne vulgaris

Identifier Type: -

Identifier Source: org_study_id