No short‐term effect of oral isotretinoin (13‐<i>cis</i> retinoic acid) on lipoprotein(a) and HDL subclasses LP‐A‐I and LP‐A‐I:A‐II in healthy volunteers

Neele, D. M.; Buytenhek, R.; Staels, Bart; Dallongeville, Jean; Wallnöfer, Andreas; Kooistra, Teake; Princen, H.M.G.

doi:10.1046/j.1365-2796.1999.00544.x

Cited by 3 publications

(3 citation statements)

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“…Therefore, routine monitoring of the drug including measurement of serum lipids and hepatic enzyme levels during and at the beginning of treatment are recommended. 39 The results of the current study indicate an insignificant difference in terms of plasma triglyceride levels between the pre-treatment and treatment groups similar to the findings of Neele et al 40 Decreased or unchanged HDL-cholesterol levels have also been reported, and the current study also showed a significant decrease in plasma HDL-cholesterol levels after isotretinoin therapy. Moderate-to-severe serum lipid and transaminases elevations were transient in many cases.…”

Section: Discussionsupporting

confidence: 89%

“…37,38 A marked elevation of plasma triglyceride-rich lipoproteins levels, which may result in acute pancreatitis, has been observed in only 20% patients on isotretinoin treatment. 39 The results of the current study indicate an insignificant difference in terms of plasma triglyceride levels between the pre-treatment and treatment groups similar to the findings of Neele et al 40 Decreased or unchanged HDL-cholesterol levels have also been reported, and the current study also showed a significant decrease in plasma HDL-cholesterol levels after isotretinoin therapy. 41 Increased levels of transaminases are usually mild and moderate and without hepatic injury under isotretinoin therapy.…”

Section: Discussionsupporting

confidence: 89%

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Isotretinoin treatment induces oxidative toxicity in blood of patients with acne vulgaris: a clinical pilot study

Erturan

Nazıroğlu

Akkaya

2012

Cell Biochemistry & Function

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Acne vulgaris is the one of the most common skin diseases. Although isotretinoin (13-cis-retinoic acid) is an effective and well-tolerated medication, it has a wide range of side effects. Because the effects of isotretinoin on oxidant and antioxidant systems have not yet been clarified, we investigated plasma and erythrocyte antioxidant vitamins, lipid peroxidation (LP), reduced glutathione (GSH) and glutathione peroxidase (GSH-Px) values in patients with acne vulgaris before and after isotretinoin treatment. The study was performed on the blood plasma and erythrocytes of 31 acne vulgaris patients. Blood samples were taken from the patients before treatment and after isotretinoin (oral and 0·5-0·7 mg·kg(-1)) treatment for 2 months. Plasma amtioxidant vitamins, erythrocyte malondialdehyde, GSH and GSH-Px levels were measured. Plasma vitamin E (p < 0·001), lipid peroxidation (LP) and serum high-density lipoprotein cholesterol (p < 0·001) values were significantly lower in the treatment group than in the pre-treatment group, although erythrocyte LP (p < 0·001), GSH (p < 0·01) and GSH-Px (p < 0·001), aspartate aminotransferase (p < 0·05), alanine aminotransferase (p < 0·05), density lipoprotein cholesterol (p < 0·001) and total cholesterol (p < 0·01) levels were significantly higher in the treatment group than in the pre-treatment group. Vitamins A, C and β-carotene concentrations did not change significantly between the two groups. In conclusion, the results of the current study indicate that isotretinoin treatment induces oxidative stress and liver damage by decreasing plasma vitamin E and increasing erythrocytes GSH-Px, GSH and liver enzyme values.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Isotretinoin treatment induces oxidative toxicity in blood of patients with acne vulgaris: a clinical pilot study

Erturan

Nazıroğlu

Akkaya

2012

Cell Biochemistry & Function

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“…The data presented here support the conclusion that limited blood testing should be performed for most patients and that more complete blood testing be done for those patients with a significant response in liver enzymes, cholesterol or triglycerides. It is still up to the individual physician to determine the appropriate response to elevated blood levels [17, 18, 19, 20, 21]. …”

Section: Discussionmentioning

confidence: 99%

A Proposed Set of New Guidelines for Routine Blood Tests during Isotretinoin Therapy for Acne vulgaris

Altman

2002

Dermatology

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Background: Isotretinoin has been proven to be an effective treatment for acne vulgaris. The enclosed package insert with isotretinoin suggests weekly/biweekly laboratory testing (hepatic functions and lipid analysis) but fails to recommend the needed action levels for abnormalities. Methods: We provide a statistical analysis of a retrospective study of 141 individuals’ course of therapy on isotretinoin and their laboratory blood analysis results. Results: Very few statistically significant elevations in liver enzymes or lipid profiles occurred. More importantly, in only 1 case did these elevations warrant the discontinuation of therapy. Conclusion: The data presented here support the conclusion that limited blood testing should be performed for most patients and that more complete blood testing be done only for those patients with a significant response in liver enzymes, cholesterol or triglycerides. A set of guidelines is proposed for the practicing physician to interpret blood test results.

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Drug-Induced Lipid Changes

et al. 2001

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Many drugs besides lipid-lowering drugs affect serum lipid levels in either a potentially harmful or beneficial way, and may therefore increase or decrease the risk of cardiovascular disease. Diuretics, beta-blocking agents, progestogens, combined oral contraceptives containing 'second generation' progestogens, danazol, immunosuppressive agents, protease inhibitors and enzyme-inducing anticonvulsants adversely affect the lipid profile. They increase total cholesterol, low density lipoprotein cholesterol and triglycerides by up to 40, 50 and 300%, respectively, and decrease high density lipoprotein cholesterol by a maximum of 50%. Conversely, alpha-blocking agents, estrogens, hormone replacement therapy, combined oral contraceptives containing 'third generation' progestogens, selective estrogen receptor modulators, growth hormone and valproic acid show mostly beneficial effects on the lipd profile. Some drugs, for example, isotretinoin, acitretin and antipsychotics, mainly elevate triglyceride levels. Adverse or beneficial effects on serum cholesterol levels do not always translate into a higher or lower, respectively, incidence of cardiovascular disease. because these drugs may influence cardiovascular risk through multiple pathways. In some cases, excessive cholesterol levels occur, for example, with protease inhibitor therapy, and several cases of pancreatitis attributable to drug-induced hypertriglyceridaemia have been reported. Some general guidelines on the management of drug-induced dyslipidaemia can be given. Replacement of the dyslipidaemia-inducing drug by an equivalent alternative therapy is preferred. However, such alternatives are often difficult to find. If there is no equivalent alternative and treatment with the dyslipidaemia-inducing drug must be initiated, monitoring of serum lipid levels is important. If drug use is expected to be long term, the existing guidelines for the management of dyslipidaemia in the general population can be applied to drug-induced dyslipidaemia. In cases of extreme hyperlipidaemia, medication use should be reassessed.

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No short‐term effect of oral isotretinoin (13‐cis retinoic acid) on lipoprotein(a) and HDL subclasses LP‐A‐I and LP‐A‐I:A‐II in healthy volunteers

Cited by 3 publications

References 20 publications

Isotretinoin treatment induces oxidative toxicity in blood of patients with acne vulgaris: a clinical pilot study

Isotretinoin treatment induces oxidative toxicity in blood of patients with acne vulgaris: a clinical pilot study

A Proposed Set of New Guidelines for Routine Blood Tests during Isotretinoin Therapy for Acne vulgaris

Drug-Induced Lipid Changes

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