'Oral isotretinoin plus desloratadine for acne vulgaris: an updated global meta-analysis of efficacy, safety, and patient-centered outcomes'.

BACKGROUND

Acne vulgaris is a common skin disorder that negatively affects adolescents' quality of life. Recent evidence suggests that combining isotretinoin with desloratadine may enhance treatment outcomes.

OBJECTIVE

To evaluate the efficacy and safety of oral isotretinoin plus desloratadine compared with isotretinoin monotherapy in acne vulgaris patients.

METHODS

A systematic search in PubMed, Web of Science, and CENTRAL was conducted until August 2025, encompassing nine clinical trials with 608 patients. Risk of bias was assessed using the ROB-2 tool, and data were analyzed with RevMan version 5.4.1.

RESULTS

Combination therapy significantly reduced GAGS scores at 4 weeks (MD: -2.53; 95% CI: -4.10 to -0.96; p = 0.002), 12 weeks (MD: -3.62; 95% CI: -4.98 to -2.26; p < 0.00001), 16 weeks (MD: -2.13; 95% CI: -3.43 to -0.84; p = 0.001), and 24 weeks (MD: -2.52; 95% CI: -3.58 to -1.46; p < 0.00001). Clinical efficacy (>90% GAGS reduction) was higher with combination therapy (OR: 2.39; 95% CI: 1.19 to 4.78; p = 0.01). In addition, combination therapy was associated with reduced flare-ups (OR: 0.38; p = 0.009) and pruritus (OR: 0.13; p < 0.00001). Patient satisfaction was greater, with no significant changes observed in laboratory safety parameters.

CONCLUSION

Isotretinoin with desloratadine offers superior efficacy and tolerability, ensuring higher patient satisfaction without safety risks.