Un traitement novateur contre l’acné tarde à arriver en Europe

Un traitement novateur contre l'acné tarde à arriver en Europe

After several decades, this is the first real breakthrough against acne. Clascoterone, a promising treatment, has been prescribed for several months in the United States, but it is not known in Europe when this drug will be available.

“What is really promising with clascoterone is that it acts through a completely new mechanism on (the causes) of hormonal acne”, summarizes the American dermatologist John Barbieri to AFP.

From the end of 2021, American doctors can prescribe this cream against acne, a skin disease from which it is very rare to escape during life. Acne, oily skin, and pimples affect three out of four teens. Many adults are also affected.

Nothing new for 40 years.

Faced with such a widespread disease, therapeutic innovations are scarce, although research has recently advanced to other levels, such as the effects of diet. Before the appearance of clascoterone, anti-acne treatments had not registered any novelty for almost 40 years.

Topical treatments were previously divided into two broad categories: those that kill acne-causing bacteria with antibiotics, and those that limit the buildup of dead skin cells, a process that promotes inflammation.

Clascoterone makes skin cells less receptive to hormones that produce sebum, the oily substance that acne sufferers produce in excessive amounts. Other treatments, taken orally, also act at the hormonal level. But these are usually birth control pills, so they are given exclusively to women. And, by directly influencing the production of hormones, they cause much more serious disorders in the body.

It’s not a miracle drug

However, a new mechanism of action is far from guaranteeing the interest of a drug, it must also prove that it works. This is the case of clacosterone, which a study, published in 2020 in Jama Dermatology, showed to be more effective than a placebo administered blindly and without significant side effects.

This study was conclusive enough for US authorities to approve the treatment. But don’t expect a miracle drug or an acne revolution, either.

The study “is not compared with existing treatments, so we do not know very well how to place all that,” French dermatologist Emilie Sbidian tells AFP. However, she considers this new drug “very interesting” because it could offer new hope to patients reluctant to other treatments, or even be administered together with them to increase their effectiveness.

Pharmaceutical giants are not interested in dermatology

However, it is not on the agenda in Europe, where there is no indication of when the treatment will be available. Reluctance of the health authorities? Not even: the European Medicines Authority (EMA) told AFP it had not started evaluating the drug.

The answer lies in the choices of the company that produces the drug, the Swiss Cosmo Pharma. “As we are a very small group, we first focused on authorization in the world’s largest market, the United States,” where the treatment is now distributed by another company, Sun Pharma, Diana Harbort, head of the drug unit, told AFP. Cosmo dermatology.

According to Ms. Harbort, the dermatology market is not of interest to the pharmaceutical giants, such as the American Pfizer and the French Sanofi, and Cosmo must find a different partner for each region of the world.

It just got it in China, which it announced at the end of July during its quarterly results. But, in Europe, nothing new.

Strategic mistake?

Why does it take so long to find a partner? The group evokes a market slowed down for a long time by the Covid-19 crisis, but this explanation does not convince all observers. “The dermatological market is quite buoyant,” financial analyst Jamila El Bougrini told AFP. “I think there were mistakes in the group’s strategy. »

The analyst, who does not understand why no evaluation has been initiated with the European authorities, recalls in particular an unfortunate choice made by Cosmo in recent years: the group wanted to resell its dermatology division, of which clascoterone was the only product before giving it to him. due to lack of buyer.

“Weren’t they too greedy?” asks Ms El Bougrini, who finds it hard to interest investors if a treatment doesn’t seem more effective than existing drugs.

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