Hilary Baldwin, MD: IDP-126 May Change Acne Management

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The first triple-combination topical drug for acne may be available by the end of this year. One expert has high hopes for it.

The field of acne treatment is anticipated a major breakthrough in the next year—one that which may change the hierarchy of prescribing strategies from the top down.

In the second segment of an interview with HCPLive during the Maui Derm 2023 NP + PA Summer Conference in Colorado Springs this week, Hilary Baldwin, MD, medical director of the Acne Treatment & Research Center in New York, discussed lindamycin phosphate / benzoyl peroxide / adapalene gel (IDP-126), an investigative tripe-combination topical therapy from Ortho Dermatologics that has fared significantly well in the treatment of moderate to severe acne in phase 2 and 3 trials.

The US Food and Drug Administration (FDA) accepted Ortho’s New Drug Application (NDA) for IDP-126last month, and will decide on its application by late October. If approved, it would be the first triple-combination therapy indicated to treat acne—a breakthrough that Baldwin said she and colleagues have waited years to accomplish.

“It takes care of the inflammation, the bacteria, and the follicular hyperkeratinization that’s part in parcel of acne,” she said. “The phase 2 and 3 trials showed excellent efficacy—not only compared to vehicle, but also compared to the (double-combination therapies), the one’s we’ve been relying on all these years. I think it’s going to blow me away.”

Her anticipation is that IDP-126 will move immediately to the top of her treatment strategies.

“I think a better question is, ‘Where does it not fit?’” Baldwin said. “I don’t see a scenario, except for maybe pregnancy, where I wouldn’t reach for this first.”

Baldwin additionally discussed her involvement with the Personalizing Acne: Consensus of Experts (PACE) panel, an 18-member consortium of acne experts re-establishing best practices for patient-centered acne management. The general sentiment of the panel was that the acne care journey must become more personalized with the individual patient.

“We talk in means when we go over data: we talk about the mean patient type, the mean patient efficacy and tolerability,” Baldwin said. “And the point is you need to focus on that person in front of you and forget about the rest of the world. We need to take into consideration all their habits and lifestyle…personalizing it to the individual.”

Among the ways dermatologists can better do this is to take into better consideration treatment after-effects including post-inflammatory erythema, post-inflammatory hyperpigmentation, and acne scarring, Baldwin said. Another critical facet of acne care is keeping consideration for the psychological effects of the disease.

That’s a crucial part of the whole acne process and the life of an acne patient,” Baldwin said.

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