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Acne VulgarisPhase 3FASCENCT03334682

Randomized Double-blind Study on the Benefit of Spironolactone for Treating Acne of Adult Woman.

A Phase 3 study testing spironolactone and Doxycycline in people with Acne Vulgaris, run by Nantes University Hospital at 9 sites in France.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Acne vulgaris of adult woman has increased over the past 10 years; it affects currently 20% to 30% of adult women. The physiopathology of adult woman acne is distinguished from the teenager one by essentially 2 factors: hormonal factor with a peripheral hyperandrogenism coupled with an hypersensibility of cutaneous… Read more about this study

Who is it for?
Ages 20 years and older, women only
Conditions the study is for
Acne Vulgaris
What is being tested?
spironolactone and Doxycycline
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
158 participants
Where
9 sitesFrance
Study dates
31 Jan 2018to 4 Jul 2023
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient with acne, with at least 10 inflammatory lesions and no more than 3 nodules
  • Patient who already had one cycline course for her acne treatment with a 3 months* wash out or who never had any cycline
  • Patient having signed an informed consent
  • Absence of use of oral antibiotics and Zinc salts in the last 30 days
  • Absence of use of systemic isotretinoin and antiandrogens in the last 6 months
  • Absence of microphysiotherapy in the last 15 da
  • Women of child-bearing age under contraception since 3 months (oral contraception, implant or IUD).
  • Patients with social security

Who cannot join

  • Patient affected by active /progressive diseases, as infections including Hidradenitis suppurativa, cancers, or endocrine syndrome (eg polycystic ovary syndrome), Addison's disease)
  • Patient affected by Rosacea
  • Patient with contra-indication to the use of one of the investigational products or auxiliary :
  • Patient with intolerance or hypersensitivity to cyclin's, spironolactone or to any ingredient present in associated benzoyl peroxide gel
  • Patient with significant impairment of renal excretory function, acute or chronic renal failure, anuria.
  • Patient with life-threatening or very severe hepatic impairment.(grade III or IV)
Show all 12Show fewer
  • Patient with hyperkalaemia or strongly requiring potassium-sparing diuretics (eg amiloride, canrenoate, eplerenone, triamterene), or treated continuously with Angiotensin-converting-enzyme (ACE) inhibitors, angiotensin II antagonist, NSAIDs, heparin and molecular weight heparin, ciclosporin and tacrolimus.
  • Patient requiring topical isotretinoin or who stopped this drug since less than 2 weeks
  • Patient previously treated with spironolactone
  • Pregnant woman or likely to become pregnant or nursing and refusing to use an effective contraceptive method
  • Patient participating in another interventional clinical trial
  • Patient under guardianship or trusteeship

Trial locations and contacts

9 sites in 1 country.

9 sites in 1 country

France9 sites
  • Chru Brest

    Brest

  • CHU Caen

    Caen

  • CHU Grenoble

    Grenoble

  • CH La Rochelle

    La Rochelle

  • CH Le Mans

    Le Mans

  • CHU de Nantes - Dermatologie

    Nantes

  • CHU Poitiers

    Poitiers

  • Cabinet du Dr Jean-Paul Claudel

    Tours

  • CHRU Tours

    Tours

Other trials in France

About this study

Acne vulgaris of adult woman has increased over the past 10 years; it affects currently 20% to 30% of adult women.

The physiopathology of adult woman acne is distinguished from the teenager one by essentially 2 factors:

Read more
  • hormonal factor with a peripheral hyperandrogenism coupled with an hypersensibility of cutaneous androgens receptors of these women. But this point is still at the stage of hypothesis.
  • inflammatory factor linked with Propionibacterium Aces ; indeed these women received most of the time many cures of local and systematic antibiotics at the origin of resistant Propionibacterium Aces strains which lead to a chronical activation of cutaneous innate immunity.

On a therapeutic plan, four types of systemic treatment, approved in this indication are:

  • Tetracyclines which are problematic for the bacterial resistance and consequently constant relapse when they are stopped.
  • Zinc salts which target only the inflammatory lesions and were shown less effective than cycline
  • Antiandrogens, with acetate of cyproterone associated with risks of phlebitis and pulmonary embolism, and increase risk of triglycerides, cholesterol and hepatic balance.
  • The last alternative is represented by isotretinoin but the use in women of childbearing potential is binding because of the teratogen risks and the hyperandrogenism represents an identified risk of relapse.

In this context, the spironolactone could represent an interesting alternative. It blocks the 5-alpha-reductase receptors at sebaceous gland and inhibits Luteinizing hormone (LH) production at the pituitary level. It is not submitted to isotretinoin constraints, does not lead to bacterial resistance and targets the peripheral hyperandrogenism.

Currently, very few studies have been performed and on a weak number of patients but they showed that at low doses (lower than 200mg/day), spironolactone can be effective against acne.

In that context, it seemed clearly interesting to perform the first double-blind randomized study spironolactone vs cyclines which remains the moderate acne reference treatment and to demonstrate the superiority of spironolactone's efficacy in order to establish it as alternative way to cycline.

Conditions
Acne Vulgaris
Being tested
spironolactone, Doxycycline
Medical subject headings
Acne Vulgaris

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • spironolactoneDrug

    Dispensation of spironolactone at each visit according to the arm description described above.

  • DoxycyclineDrug

    Dispensation of doxycycline then placebo, at each visit according to the arm description described above.

Study groups in NCT03334682
Study groupRoleWhat they receive
spironolactoneExperimentalSpironolactone ARROW ® 75 mg, 150mg, orally, once a day during all the trial (12 months: 6 months on double-blinded spironolactone then 6 months on open-label spironolactone), + topical therapy during all the trial (benzoyl peroxide 5%)
Receives: Drug: spironolactone
doxycyclineActive comparator(Doxycycline Sandoz 100 mg), 100mg/day during 3 months followed by placebo during 3 months, on double-blinded + topical therapy during all the trial (benzoyl peroxide 5%
Receives: Drug: Doxycycline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Treatment efficacy

    The treatment's efficacy will be determined by the rate of success in each arm. The best rate of success between Month 4 and Month 6 will be chosen for the final result. Rate of success, defined by a decrease of both Adult Female Acne Scoring Tool (AFAST) scores 1 and 2:

    1. AFAST score 1: decrease of at least 2 grades compared to baseline or to grade 0 if the baseline was at 1 and
    2. AFAST score 2: decrease to grade 1 if baseline was > 1 or to grade 0 if the baseline was at 1

    AFAST 1 (also called GEA) assesses the comedones (open and closed), the non-inflammatory lesions, the papules and pustules and the nodules. The stage is defined according to a global evaluation of severity of acne and ranges from Grade 0 (no acne) to Grade 5 (the worse situation).

    AFAST 2 assesses acne on an area from the left and right mandibular zone to the upper edge of the trunk and ranges from Grade 0 (no acne) to Grade 3 (the worse situation).

    Measured: Month 4 and Month 6

Secondary outcomes (18)
  1. Clinical adverse events

    Number and type of Adverse Events (AE) and Serious Adverse Events (SAE) occurring from the beginning of the treatment until end of the follow-up

    Measured: Within 12 months after randomization

  2. Sodium abnormal values (biological adverse events)

    Sodium measurement (mmol/L)

    Measured: From 30 days to 7 days before randomization visit, Month 2, Month 4, Month 9

  3. Potassium abnormal values (biological adverse events)

    potassium measurement (mmol/L)

    Measured: From 30 days to 7 days before randomization visit, Month 2, Month 4, Month 9

  4. Chlore abnormal values (biological adverse events)

    Chlore measurement (mmol/L)

    Measured: From 30 days to 7 days before randomization visit, Month 2, Month 4, Month 9

  5. Calcium abnormal values (biological adverse events)

    Calcium measurement (mmol/L)

    Measured: From 30 days to 7 days before randomization visit, Month 2, Month 4, Month 9

  6. AFAST score 1 (GEA) at 0 or 1

    Number of patients with AFAST score 1 (GEA) at 0 or 1.

    Measured: Month 2, Month 4, Month 6, Month 9 and Month 12

  7. AFAST score 2 (Mandibular) at 0 or 1

    Number of patients with AFAST score 2 (Mandibular) at 0 or 1.

    Measured: Month 2, Month 4, Month 6, Month 9 and Month 12

  8. AFAST score 1 associated with AFAST score 2 at 0 or 1

    Number of patients with both AFAST score 1 and AFAST score 2 at 0 or 1.

    Measured: M2, M4, M6, M9 and M12

  9. Quality of life (cost-utility assessment and general quality of life assessment)

    EQ-5D (EuroQol 5 dimensions) questionnaire: The questionnaire focuses on five dimensions: mobility, personal autonomy, current activities, pain/discomfort, and anxiety/depression. For each of these dimensions, three answers are possible.

    Measured: Month 2, Month 4, Month 6, Month 9 and Month 12

  10. Quality of life (specific to acne)

    Cardiff Acne disability Index (CADI) is a disease-specific questionnaire measuring disability induced by acne.

    Measured: Month 2, Month 4, Month 6, Month 9 and Month 12

  11. Bacterial and parasital evaluations

    Presence of P acnes, M Furfur and S epidermidis, aureus

    Measured: Day 0 (baseline) and Month 4

  12. Inflammatory lesions of the face

    Number of inflammatory lesions of the face

    Measured: Day 0 (baseline), Month 2, Month 4, Month 6, Month 9 and Month 12

  13. retentional lesions of the face

    Number of retentional lesions of the face

    Measured: Day 0 (baseline), Month 2, Month 4, Month 6, Month 9 and Month 12

  14. Face lesions

    Total number of face lesions

    Measured: Day 0 (baseline), Month 2, Month 4, Month 6, Month 9 and Month 12

  15. Trunk lesions

    Factor F2 of ECLA scale ECLA ("Echelle de Cotation des Lésions d'Acné") is a scale for acne proposed by the dermatology research team of Nantes University Hospital. It is composed of 3 factors: Factor 1 (F1) counts the acne lesions on the face; Factor 2 (F2) counts the lesions acne on the trunk and Factor 3 (F3) counts the scars. In this study, the factor F2 will be used. The factor F2 assesses the extensive character of acne lesions on 5 defined areas: cervical areas (F2N); chest areas (F2C); back area (F2B) and arm area (F2A) according to a qualitative scale 0=absent, 1=poor 2=medium 3=significant. It is completed by the count of the present nodules in each area.

    Measured: Day 0 (baseline), Month 2, Month 4, Month 6, Month 9 and Month 12

  16. Relapse

    number of patients with relapse, defined as follows :

    1. AFAST score 1 (GEA score): increase of 2 points versus score of previous visit, in case of success Or
    2. AFAST score 2 (mandibular score): increase of 1 point versus score of previous visit, in case of success

    Measured: Month 4 and Month 6

  17. Reappearance of 10% and more of inflammatory lesions.

    Number of patients with a reappearance of 10% and more of inflammatory lesions.

    Measured: Month 6

  18. Incremental cost-effectiveness ratio (cost per Quality-Adjusted Life-Year, QALY) of the comparison between the spironolactone and cycline.

    costs: resources consumed, QALY: EQ-5D

    Measured: Month 6

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Nov 2017
  2. Study start31 Jan 2018
  3. Primary completion3 Feb 2023
  4. Study completion4 Jul 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
158 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03334682
Sponsor's protocol ID
RC16_0467
Acronym
FASCE
Status last verified
Jul 2023
First submitted
30 Oct 2017
Last updated
14 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Dreno B, Nguyen JM, Hainaut E, Machet L, Leccia MT, Beneton N, Claudel JP, Celerier P, Le Moigne M, Le Naour S, Vrignaud F, Poinas A, Dert C, Boisrobert A, Flet L, Korner S, Khammari A. Efficacy of Spironolactone Compared with Doxycycline in Moderate Acne in Adult Females: Results of the Multicentre, Controlled, Randomized, Double-blind Prospective and Parallel Female Acne Spironolactone vs doxyCycline Efficacy (FASCE) Study. Acta Derm Venereol. 2024 Feb 21;104:adv26002. doi: 10.2340/actadv.v104.26002.

    PubMed 38380975
  • Poinas A, Lemoigne M, Le Naour S, Nguyen JM, Schirr-Bonnans S, Riche VP, Vrignaud F, Machet L, Claudel JP, Leccia MT, Hainaut E, Beneton N, Dert C, Boisrobert A, Flet L, Chiffoleau A, Corvec S, Khammari A, Dreno B. FASCE, the benefit of spironolactone for treating acne in women: study protocol for a randomized double-blind trial. Trials. 2020 Jun 25;21(1):571. doi: 10.1186/s13063-020-04432-w.

    PubMed 32586344

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing spironolactone and Doxycycline in people with Acne Vulgaris, run by Nantes University Hospital at 9 sites in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 14 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Treatment efficacy (time frame: Month 4 and Month 6). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03334682, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Sep 2026.

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