Clascoterone cream 1% targets androgen receptors

The topical cream is the first acne drug with a new mechanism of action to win FDA approval in the last 40 years.On August 27, 2020, the U.S. FDA approved clascoterone 1% cream (Winlevi; Cassiopea) for the treatment of acne in patients 12 years and older.¹ Clascoterone cream 1% is a ­first-in-class topical acne treatment that targets the androgen receptors in the skin. The last FDA approval of an acne drug with a new mechanism of action occurred nearly 40 years ago.¹ Clascoterone cream is applied as a thin layer to the affected areas twice daily; avoiding contact with eyes, mouth, and mucous membranes. The approval is based on data from two clinical trials (CB-03-01/25 and CB-03-01/26), in which clascoterone cream 1% demonstrated a reduction in acne lesions after 12 weeks of treatment. The two trials were identically designed, double-blind, placebo-controlled studies enrolling a total of 1,440 patients nine years or older. Treatment success was de­fined as an Investigator’s Global Assessment (IGA) score of 0 or 1, and a 2-grade or greater improvement from baseline and absolute change from baseline in noninflammatory and inflammatory lesion counts at week 12.² At week 12, treatment success rates in CB-03- 01/25 and CB-03-01/26 with clascoterone cream 1% were 18.4% (point estimate, 2.3; 95% CI, 1.4- 3.8; P < .001) and 20.3% (point estimate, 3.7; 95% CI, 2.2-6.3; P < .001) versus 9.0% and 6.5% with placebo, respectively. At week 12, in both CB-03-01/25 and CB-03-01/26, treatment with clascoterone cream 1% resulted in a signi­ficant reduction in absolute noninflammatory lesions from baseline to −19.4, as well as a reduction in inflammatory lesions from baseline to −19.3 and −20.0, respectively.² Overall, clascoterone cream 1% was well tolerated and demonstrated similar safety pro­file to placebo. The most common adverse events in studies were nasopharyngitis, headache and oropharyngeal pain.² “The approval of Winlevi is an exciting breakthrough in acne treatment. This game-changing topical drug offers a non-antibiotic approach to people with acne, by targeting the androgen receptors directly in the skin. It ­fills a longstanding gap in acne therapy,” says Michael Gold, M.D., investigator and medical director, Gold Skin Care Center and Tennessee Clinical Research Center. “After 40 years, it provides a much-anticipated, complementary new approach to treat acne.”¹