Evaluation of Evidence for Acne Remission With Oral Isotretinoin Cumulative Dosing of 120-150 mg/kg

Tan, Jerry; Knezevic, Sanja; Boyal, Sanwarjit; Waterman, Brad; Janik, Toni

doi:10.1177/1203475415595776

Cited by 27 publications

(24 citation statements)

References 31 publications

(155 reference statements)

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“…Elevated liver enzymes was seen in up to 13.7% of patients taking low‐dose isotretinoin, and deranged lipid profile was seen in up to 25% in various studies . In the current study, the rate was 3.3% and 2.7%, respectively.…”

Section: Discussionmentioning

confidence: 40%

“…Those with moderate acne were given a cumulative dose of 90 mg/kg and those with severe acne were given a cumulative dose of 110 mg/kg. This cumulative dose was lower than the conventional recommended cumulative dosage of between 120 mg/kg and 150 mg/kg . This cumulative dosage was decided to ensure treatment duration of between 18 and 24 months.…”

Section: Methodsmentioning

confidence: 99%

“…Classically, isotretinoin is recommended at a dose of 0.5–1.0 mg/kg daily until a cumulative dosage of 120–150 mg/kg . This regime is very effective but causes many adverse effects that are mainly dose dependent.…”

Section: Introductionmentioning

confidence: 95%

See 2 more Smart Citations

Safety and efficacy of fixed‐dose 10 mg daily isotretinoin treatment for acne vulgaris in Malaysia

Yap

2016

J of Cosmetic Dermatology

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Section: Discussionmentioning

confidence: 40%

Section: Methodsmentioning

confidence: 99%

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Safety and efficacy of fixed‐dose 10 mg daily isotretinoin treatment for acne vulgaris in Malaysia

Yap

2016

J of Cosmetic Dermatology

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“…4 Most of the patients undergoing treatment at the outpatient clinic were properly followed up, in accordance with guidelines that have been published since the 1990s. 19,20 This is important, because isotretinoin is a teratogenic drug with possible side effects. 11 On average, the therapeutic regimens used an initial daily dose of 0.33 mg/kg.…”

Section: Resultsmentioning

confidence: 99%

Use of oral isotretinoin to treat acne in the public system: a hospital-based retrospective cohort

Evaristo

Bagatin

2019

Sao Paulo Med. J.

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Acne is a chronic and multifactorial disease that involves inflammation of pilosebaceous units. 1 It mostly affects the face, but may also affect the chest and back, and it presents different cutaneous lesions depending on the severity of the disease. It affects 80% to 90% of adolescents, but can occur at any age, and it has negative psychosocial impacts that may be permanent. For this reason, acne needs to be treated as early as possible, and its management should be directed towards prevention of scars. 2,3 Measures such as proper hygiene and sunlight protection form part of the topical and/or systemic therapy for acne, according to the severity of the disease. 4 For moderate or severe forms of acne that do not respond to conventional therapy, and which tend to leave scars, oral isotretinoin is the first-line therapy. Some authors have stated that isotretinoin should be the first-line drug because of the chronic and unpredictable course of acne. 5 Isotretinoin is a synthetic analogue of vitamin A that acts epigenetically, through inhibiting sebocyte differentiation and sebaceous gland function and modulating toll-like receptors, regeneration and skin repair. It is used in monotherapy and is highly effective, leading to healing or longstanding remission, prevention and reduction of scars. 6 Despite the high efficacy of isotretinoin, its use can cause some adverse events, which vary according to the daily dose. The most common and controllable are mucocutaneous conditions (cheilitis, xerophthalmia, nasal dryness and irritative dermatitis); elevated liver enzymes and triglycerides; and changes to cholesterol levels (increased low-density lipoprotein cholesterol and decreased high-density lipoprotein cholesterol). These changes are generally mild and occur early on (after 6 to 8 weeks), and do not have any significant repercussions for the patient's subsequent follow-up. The effects are transient and reversible, and discontinuation of the treatment is only rarely required. 7,8

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“…Recent studies demonstrate that cumulative doses to achieve acne clearance vary with acne severity. Logically, clearance is required before the potential for acne remission . It is heartening that this French guideline does not perpetuate this myth.…”

mentioning

confidence: 99%

Acne guidelines: pearls, pitfalls and questions

Tan

2017

Br J Dermatol

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Evaluation of Evidence for Acne Remission With Oral Isotretinoin Cumulative Dosing of 120-150 mg/kg

Abstract: The threshold dose of 120-150 mg/kg for oral ISO is based on past parameters of treatment duration and prior studies used vague or inconsistent definitions of clearance and remission. Optimal cumulative doses of ISO required to induce remission appears to vary with severity.

Cited by 27 publications

References 31 publications

Safety and efficacy of fixed‐dose 10 mg daily isotretinoin treatment for acne vulgaris in Malaysia

Safety and efficacy of fixed‐dose 10 mg daily isotretinoin treatment for acne vulgaris in Malaysia

Use of oral isotretinoin to treat acne in the public system: a hospital-based retrospective cohort

Acne guidelines: pearls, pitfalls and questions

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