Efficacy and Safety of Oral DFD-29 Versus Doxycycline in Rosacea: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Purpose: This systematic review and meta-analysis aimed to evaluate the efficacy and safety of DFD-29, a low-dose, modified-release minocycline formulation, compared to doxycycline for the treatment of rosacea. Methods: RCTs comparing oral DFD-29 with doxycycline in adults with papulopustular rosacea were identified through systematic searches of major databases up to Mar 13, 2025. Primary outcome was Investigator’s Global Assessment (IGA) treatment success; secondary outcome was treatment-emergent adverse events (TEAEs). Meta-analysis was performed using a random-effects model. Results: Three RCTs (n = varied) were included. DFD-29 significantly improved IGA treatment success at 16 weeks compared to doxycycline (pooled OR = 2.51; 95% CI: 1.81–3.48). Although DFD-29 showed a slightly higher incidence of TEAEs (OR = 1.32; 95% CI: 0.93–1.89), the difference was not statistically significant. Conclusions: DFD-29 demonstrated superior efficacy and comparable safety to doxycycline; however, given the limited number of available trials and short follow-up duration, these findings should be considered preliminary. Larger, long-term randomized studies are warranted to confirm these results and establish the role of DFD-29 in rosacea management.