Revealing the key factors associated with acne development and treatment with a fixed combination adapalene + metronidazole

Introduction . The search for an effective approach to the treatment of аcne vulgaris is complicated by the complex interaction of factors influencing the course and outcome of the disease. Aim. To identify key associations of acne development factors and severity by reconstructing a Bayesian network and analyzing the results of treatment with a fixed combination of adapalene 0.1% + metronidazole 1% (Metrogyl® A gel). Materials and methods . The study was conducted from 2023 to 2025 in Kazan, 650 patients with acne were included, the average age was 23 ± 3.7 years. The independent parameters included: general characteristics, medical history, various clinical parameters depending on independent ones included: laboratory parameters, morphofunctional parameters and composition of the microbiota of the facial skin. The resulting parameters of the model were clinical characteristics and dermatological indices. At the first stage, a nonparametric Bayesian network was reconstructed. At the second stage, a group of patients with mild to moderate acne (n = 56) were treated with adapalene 0.1% + metronidazole 1% gel for 12 weeks. Results. The factors influencing the development and course of acne were identified, and two clusters of highly related features that describe the influence of hormone-associated and microbial pathogenesis factors were formed. Topical therapy in the group of patients with mild and moderate acne who had disorders of the skin microbiome (n = 56) with adapalene 0.1% + metronidazole 1% gel was effective: сlinical remission occurred in 60.7% (n = 34), significant improvement in 37.5% (n = 21). Local adverse reactions were characterized by mild severity and did not require drug withdrawal. Conclusions. The present approach is useful for visualization of complicated relationships between factors and clinical outcomes for analysis of complex relationships between factors and clinical outcomes in the analysis of multifactorial diseases. Based on the results of the analysis, topical acne therapy (adapalene 0.1% + metronidazole 1%, gel) in a group of patients with skin microbiome disorders showed efficacy, safety and good tolerability.