ReviewSaudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society2026
Efficacy and safety of oral doxycycline for acne vulgaris treatment: A systematic review and meta-analysis.
Review in Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Doxycycline is commonly used to manage acne vulgaris (AV), but comprehensive comparisons of its efficacy and safety against alternative treatments remain limited. This study aimed to systematically evaluate and compare the efficacy and safety of oral doxycycline with other therapeutic options for AV treatment. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted following PRISMA guidelines. Literature searches were performed in PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus, Web of Science, and Google Scholar up to March 2024, using Medical Subject Headings (MeSH) and relevant free-text terms (e.g., "doxycycline AND acne vulgaris"). The primary outcomes were treatment success, change in inflammatory lesion count, and Global Acne Grading System (GAGS) scores, while safety outcomes focused on the incidence of reported adverse events. The risk of bias across studies was evaluated using the Cochrane ROB-2 tool, and meta-analyses were conducted using random-effects models to account for expected heterogeneity. A total of 23 RCTs comprising 2,672 patients were included. Doxycycline showed similar efficacy to azithromycin in achieving treatment success (OR 1.28; 95% CI [0.54, 3.04], p = 0.57; I2 = 60%), with no significant difference in inflammatory lesion reduction (MD -0.71; 95% CI [-8.61, 7.19], p = 0.86; I2 = 97%). However, other treatments (e.g., isotretinoin, silymarin) demonstrated greater improvements in GAGS scores (MD 1.76; 95% CI [1.53, 2.00], p < 0.00001; I2 = 53%). More adverse events, particularly gastrointestinal and dermatological, were reported with doxycycline. While effective, its safety profile and comparative performance warrant further investigation through high-quality RCTs.
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