Bone mineral density and bone turnover markers in patients receiving a single course of isotretinoin for nodulocystic acne

Tekin, Nilgün Solak; Özdolap, Şenay; Sarıkaya, Selda; Keskin, Selda

doi:10.1111/j.1365-4632.2008.03534.x

Cited by 21 publications

(20 citation statements)

References 22 publications

(30 reference statements)

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“…and Leachman et al. found a decrease in BMD in Ward's triangle of the hip (7,8), whereas others found no decrease in BMD (9–11). Kindmark et al.…”

Section: Discussionmentioning

confidence: 97%

THERAPEUTIC HOTLINE: Does isotretinoin have effect on vitamin D physiology and bone metabolism in acne patients?

Ertuğrul¹,

Karadağ²,

Tutal³

et al. 2011

Dermatologic Therapy

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Isotretinoin is an effective therapy for severe nodulocystic acne. Several experimental studies suggest that it may have an effect on vitamin D physiology. In the present study, the authors aimed to investigate the effect of isotretinoin treatment on the metabolism of vitamin D in acne patients. A prospective analysis of 50 consecutive acne patients who were treated with isotretinoin for 3 months was done. Before and after 3 months of treatment, 25 hydroxy vitamin D, 1,25 dihydroxy vitamin D, and bone alkaline phosphatase, calcium, phosphate, and parathormone levels were measured. The 25 hydroxy vitamin D and serum calcium levels decreased significantly (p < 0.0001, p < 0.05, respectively), whereas 1,25 dihydroxy vitamin D, parathormone, and bone alkaline phosphatase levels increased significantly after 3 months of isotretinoin treatment (p < 0.005, p < 0.005, p < 0.0001, respectively). Aspartate aminotransferase, total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels also increased significantly after isotretinoin treatment. This prospective clinical study showed that isotretinoin has an effect on vitamin D metabolism. Further clinical studies with longer periods of follow-up are needed to understand the effect of isotretinoin on vitamin D and bone metabolism.

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“…and Leachman et al. found a decrease in BMD in Ward's triangle of the hip (7,8), whereas others found no decrease in BMD (9–11). Kindmark et al.…”

Section: Discussionmentioning

confidence: 97%

THERAPEUTIC HOTLINE: Does isotretinoin have effect on vitamin D physiology and bone metabolism in acne patients?

Ertuğrul¹,

Karadağ²,

Tutal³

et al. 2011

Dermatologic Therapy

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“…In evaluating isotretinoin specifically, 1 small prospective cohort study associated isotretinoin with minimal-to-mild bone demineralization at specific sites (such as Ward' s triangle of the femur), but revealed that these effects may be reversible. 113 Additional data from small prospective cohort 114 and case control studies 115,116 have, however, documented no measurable changes in bone mineralization markers. These changes were not associated with increased risk of fractures in those treated with isotretinoin at the standard doses and durations used for acne.…”

Section: Bone Effectsmentioning

confidence: 99%

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

et al. 2013

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INTRODUCTION: Acne vulgaris is one of the most common skin conditions in children and adolescents. The presentation, differential diagnosis, and association of acne with systemic pathology differs by age of presentation. Current acknowledged guidelines for the diagnosis and management of pediatric acne are lacking, and there are variations in management across the spectrum of primary and specialty care. The American Acne and Rosacea Society convened a panel of pediatric dermatologists, pediatricians, and dermatologists with expertise in acne to develop recommendations for the management of pediatric acne and evidence-based treatment algorithms. METHODS: Ten major topic areas in the diagnosis and treatment of pediatric acne were identified. A thorough literature search was performed and articles identified, reviewed, and assessed for evidence grading. Each topic area was assigned to 2 expert reviewers who developed and presented summaries and recommendations for critique and editing. Furthermore, the Strength of Recommendation Taxonomy, including ratings for the strength of recommendation for a body of evidence, was used throughout for the consensus recommendations for the evaluation and management of pediatric acne. Practical evidence-based treatment algorithms also were developed. RESULTS: Recommendations were put forth regarding the classification, diagnosis, evaluation, and management of pediatric acne, based on age and pubertal status. Treatment considerations include the use of over-the-counter products, topical benzoyl peroxide, topical retinoids, topical antibiotics, oral antibiotics, hormonal therapy, and isotretinoin. Simplified treatment algorithms and recommendations are presented in detail for adolescent, preadolescent, infantile, and neonatal acne. Other considerations, including psychosocial effects of acne, adherence to treatment regimens, and the role of diet and acne, also are discussed. CONCLUSIONS: These expert recommendations by the American Acne and Rosacea Society as reviewed and endorsed by the American Academy of Pediatrics constitute the first detailed, evidence-based clinical guidelines for the management of pediatric acne including issues of special concern when treating pediatric patients.

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“…At least two single-center studies have described bone lucency, or osteopenia, in subjects treated with isotretinoin [5,6]. Multiple studies with similar average treatment doses to those reported in this study have not demonstrated a decrease in the lumbar spine and hip BMD using dual X-ray absorptiometry (DXA) in pediatric or adult subjects [7][8][9][10][11]. A single-center study in [17][18][19][20][21][22][23][24][25] year-old men identified no significant difference in the spine or femoral neck BMD; however, a decrease in Ward's triangle BMD was described [2].…”

Section: Introductionmentioning

confidence: 54%

A double-blind, randomized, Phase III, multicenter study in 358 pediatric subjects receiving isotretinoin therapy demonstrates no effect on pediatric bone mineral density

Hoover

Miller²,

Galante

et al. 2015

Osteoporos Int

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Bone mineral density and bone turnover markers in patients receiving a single course of isotretinoin for nodulocystic acne

Abstract: A single course of isotretinoin therapy has no clinically significant effect on bone metabolism.

Cited by 21 publications

References 22 publications

THERAPEUTIC HOTLINE: Does isotretinoin have effect on vitamin D physiology and bone metabolism in acne patients?

THERAPEUTIC HOTLINE: Does isotretinoin have effect on vitamin D physiology and bone metabolism in acne patients?

Evidence-Based Recommendations for the Diagnosis and Treatment of Pediatric Acne

A double-blind, randomized, Phase III, multicenter study in 358 pediatric subjects receiving isotretinoin therapy demonstrates no effect on pediatric bone mineral density

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