The Adjunctive Effect of Desloratadine on the Combined Azithromycin and Isotretinoin in the Treatment of Severe Acne: Randomized Clinical Trial

Background: Desloratadine, when combined with isotretinoin, had a favorable effect in the treatment of moderate acne; however, its effect in severe nodulocystic acne remained to be elucidated. Aim of the Study: The aim of the study was to evaluate the effect of adding oral desloratadine to the combined azithromycin and isotretinoin regimen for severe acne. Patients and Methods: Patients were randomly classified into two groups: 1st (control) included 38 patients and received alternating isotretinoin and azithromycin orally and 2nd (intervention) group included 38 patients and received same regimen plus desloratadine 5 mg/day. Assessment was made at baseline, 4, 8, and 12 weeks of the trial. Results: In both groups, there was statistically significant reduction in count of inflammatory lesions at 12 weeks compared to baseline (59 +/- 19-9 +/- 7 for 2nd group and from 57 +/- 18 to 21 +/- 8 for control) (P < 0.05) and it was significantly higher in 2nd than in 1st control (P < 0.05). Significant reduction in non-inflammatory lesions count (from 18 +/- 3 to 8 +/- 2 and 18 +/- 4 to 11 +/- 2 for 2nd and 1st group, respectively ). At 12th week, 19 (50%) patients in the intervention and 12 (31.6%) of control groups were achieved excellent improvement (>80%). Conclusion: Oral desloratadine had antiacne properties, and when combined with azithromycin plus isotretinoin protocol, it significantly improves severe acne lesions and minimizes the adverse drug reactions.