In this episode, guest John Barbieri, MD, MBA, discusses the FDA's 2023 proposed changes to the iPledge system and the impacts of clinical trials and treatments on patients with hormonal acne. •    Intro 0:28 •    John Barbieri, MD, MBA 0:42 •    What does it mean to have a conditional recommendation, and why is this considered "controversial"?  1:50 •    What are the reasons, such as limitations of use, that lead to a conditional recommendation?  2:48 •    How would you implement these care guidelines into clinical practice?  3:53 •    Why is a medication like minocycline in the conditional category relative to other medications?  5:55 •    Tell us about some of the recent studies on spironolactone that have come out of the UK and France, and what we've learned from them. 7:10 •    Did they monitor any lab tests during these studies? 9:57 •    Can you tell us about the NIH-funded trial you are leading in the US? 10:36 •    Who uses spironolactone? How do you start this drug? 11:38 •    What is currently happening with iPledge? 13:04 •    How will these changes work operationally? What kind of home pregnancy test is used for patients? 15:20 •    When can clinicians expect these changes to iPledge to be implemented? 16:42 •    Thank you, Dr. Barbieri. 17:15 John Barbieri, MD, MBA, is the director of the Advanced Acne Therapeutics Clinic at Brigham and Women's Hospital in Boston. We'd love to hear from you! Send your comments/questions to Dr. Gelfand at [email protected]. Follow Dr. Gelfand on LinkedIn. For more, be sure to visit the Beneath the Surface video blog on Healio.com.  Disclosures: Gelfand and Barbieri report no relevant financial disclosures.

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