Assessment of auditory function and lipid levels in patients receiving oral isotretinoin (13-cis retinoid) therapy for acne vulgaris

Abstract

Introduction: Isotretinoin (13-cis retinoid) is a synthetic retinoid. It was approved by the FDA in 1982 for use of oral isotretinoin in severe acne. It is also used in moderate-severe acne that does not respond to conventional treatments. Isotretinoin is the only available drug that affects all stages of acne pathogenesis. Aim: To prospectively investigate whether there is an effect of isotretinoin therapy on auditory function and, if so, to demonstrate its association with simultaneous blood lipid levels. Material and methods: Thirty patients (60 ears) with acne vulgaris, who received 0.5 mg/kg of isotretinoin therapy, were included in the study. Distortion product otoacoustic emissions (DPOAEs) and pure tone audiometry tests were performed to evaluate auditory function at the beginning of the procedure and the 6 th month of treatment. In addition, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total cholesterol, triglyceride, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) cholesterol levels were recorded. Results: There was no statistically significant difference between pre-treatment and post-treatment mean pure tone audiometry threshold and DPOAE values; however, the increase in total blood cholesterol, triglyceride and LDL levels and the decrease in HDL levels were statistically significant. Conclusions: According to our study findings, isotretinoin did not cause worsening of the bilateral hearing threshold, but increased blood lipid levels. There is no need for follow-up auditory functions in routine practice during therapy, but blood lipid levels should be monitored.

Evaluation of oral isotretinoin effects on hearing system in patients with acne vulgaris: Reversible or not?

“…They evaluated auditory function at the beginning of the treatment and the sixth month of the treatment with liver function tests and lipid status. No statistically significant differences were found between pre‐treatment and post‐treatment mean pure‐tone audiometry threshold and distortion product otoacoustic emissions (DPOAE) values although they found statistically significant increases in total blood cholesterol, triglyceride, and LDL levels, and decreases in HDL levels 19 . The difference of our study from this study is that they did not perform auditory function tests in the first week, first month, and third month in patients.…”

“…18 LDL levels, and decreases in HDL levels. 19 The difference of our study from this study is that they did not perform auditory function tests in the first week, first month, and third month in patients. They found no audiometry threshold changes; thus, there was no need to evaluate auditory function tests after stopping the treatment.…”

Effect of Evening Primrose Oil Supplementation on Selected Parameters of Skin Condition in a Group of Patients Treated with Isotretinoin—A Randomized Double-Blind Trial

“…It demonstrates efficacy in the treatment of moderate, severe and recurrent acne, leading to reliable skin improvement [ 7 , 11 , 12 , 13 , 14 , 15 , 58 ]. However, there are a number of adverse side effects that limit the use of isotretinoin, including teratogenic effects [ 11 ], inducing liver disorders and dysfunction [ 21 , 30 , 59 ], changes in the lipid profile and especially an increase in total cholesterol, LDL fraction cholesterol, very low-density lipoprotein (VLDL), plasma triglycerides and a decrease in HDL fraction cholesterol [ 32 , 33 , 52 , 60 ]. The adverse effects of isotretinoin also affect the skin and mucous membranes.…”

Effect of Evening Primrose Oil Supplementation on Biochemical Parameters and Nutrition of Patients Treated with Isotretinoin for Acne Vulgaris: A Randomized Double-Blind Trial

“…In ten acne patients treated with isotretinoin at a dose of 0.8 mg/kg body weight, TCH, LDL, and TG increased after 4 weeks of treatment. An increase in TCH, TG, and LDL and a decrease in HDL were also observed in 30 patients treated with 0.5 mg/kg isotretinoin [ 55 ]. In patients with PCOS complicated by severe cystic acne, isotretinoin treatment also significantly increased TG and TCH levels [ 36 ].…”