Standardized laboratory monitoring with use of isotretinoin in acne

Hansen, Timothy J.; Lucking, Steven E.; Miller, Jeffrey J.; Kirby, Joslyn S.; Thiboutot, Diane; Zaenglein, Andrea L.

doi:10.1016/j.jaad.2016.03.019

Cited by 72 publications

(83 citation statements)

References 18 publications

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“…(19) In a study done in USA in 2016, the mean duration of treatment before elevations in levels of liver enzymes and cholesterol were detected after 61.9 days for ALT, and 50.1 days for cholesterol. (20) The limitations of the study included the difficulty in finding patients with baseline investigations and hence taking more time than expected to reach the required sample size of severe acne patients with the predetermined inclusion criteria. Also, the nature of the used study design (cross sectional) made the researchers unable to generalize their results.…”

Section: Discussionmentioning

confidence: 99%

Oral Isotretinoin and its Association with Liver Functions and Cholesterol Level among Acne Patients

Abdelaziz

El-Kamshoushy

Sherif

et al. 2020

Journal of High Institute of Public Health

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Background & Objective(s):Isotretinoin has a dramatic effect in treating acne vulgaris but it has numerous widespread adverse effects. The study aimed to investigate the association between isotretinoin and liver functions and cholesterol level among acne patients. Methods: A cross-sectional study was conducted in outpatient clinic of Dermatology Department of Alexandria Main University Hospital among 285 acne patients on isotretinoin for more than one month and less than 6 months with normal baseline serum liver enzymes and cholesterol laboratory investigations. An interview questionnaire was used to collect sociodemographic data, pattern of drug use, and laboratory investigations data following treatment with isotretinoin. Results: The mean age of patients was 20.84±3.4 years and 68.4% of them were females. Regarding pattern of using the drug, 36.8% of cases took 80 mg/day for 4-6 months. Almost 30% of cases had elevation in alanine aminotransferase (ALT) level, 23.2% had elevation in aspartate aminotransferase (AST) level and 21.1% of the cases had elevation in cholesterol level. There was a weak positive correlation between dose, duration of taking the drug and elevation in the liver enzymes and cholesterol level. Conclusion: There was a significant difference in level of liver enzymes and serum cholesterol level before and after using the drug. The dose and duration of taking the drug are factors affecting the elevation of serum liver enzymes and cholesterol level.

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Section: Discussionmentioning

confidence: 99%

Oral Isotretinoin and its Association with Liver Functions and Cholesterol Level among Acne Patients

Abdelaziz

El-Kamshoushy

Sherif

et al. 2020

Journal of High Institute of Public Health

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“…Monitoring of serum levels of hepatic enzymes and lipids before and during treatment is a routine procedure in evaluating patients who are prescribed isotretinoin therapy (Hansen et al, ; Kızılyel, Metin, Elmas, Çayır, & Aktaş, ; Vieira, Beijamini, & Melchiors, ).…”

Section: Discussionmentioning

confidence: 99%

The effects of isotretinoin therapy on the biliary system

Kurtipek

Demirbaş

et al. 2019

Dermatologic Therapy

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The aim of the present study was to investigate the potential effects of isotretinoin on the biliary system in patients with acne vulgaris receiving isotretinoin therapy. This was a preliminary retrospective study involving 40 patients with severe acne vulgaris who attended the dermatology clinic and were administered different doses (20 or 30 mg/day) of isotretinoin. Serum levels of AST, ALT, ALP, GGT, total bilirubin, direct bilirubin, and indirect bilirubin at the beginning and at the first month of therapy were scanned, recorded, and statistically analyzed. Total and indirect bilirubin levels at the first month of treatment in 30 patients, receiving isotretinoin at a dose of 20 mg/day, were significantly lower compared to the baseline values (p = .02 and p = .03, respectively), whereas AST and GGT serum levels were significantly higher (p = .003 and p = .006 respectively). No significant reduction in total and indirect bilirubin levels was detectable at the first month of treatment in 10 patients receiving isotretinoin at a dose of 30 mg/day; however, AST, ALP, and GGT levels were significantly elevated in these patients (p = .023; p = .004; and p = .001, respectively). To our knowledge, there is no previous study investigating the effects of isotretinoin on the biliary system, and, therefore, the present study is a preliminary one. Our findings implicate that low dose (20 mg/day) isotretinoin therapy can potentially reduce total and indirect bilirubin levels. Long‐term, large‐scale, prospective studies with patients receiving different doses of isotretinoin may provide more reliable information regarding the bilirubin lowering effects of isotretinoin and optimum dosing for achieving this clinical effect.

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“…Topical or systemic treatments such as oral antibiotics and oral isotretinoin could be chosen according to acne severity. Isotretinoin was proven by the Food and Drug Administration for the treatment of severe acne and has the potential to effect all of the pathogenetic pathways on acne (2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

“…Oral isotretinoin is a derivative of vitamin A, which acts as a synthetic isomer of retinoic acid (3)(4)(5). Its effect depends on sebocyte apoptosis, which results from isotretinoininduced expression of the apoptotic protein tumour necrosis factor inducing ligand, insulin-like growtha factorbinding protein-3 (5).…”

Section: Introductionmentioning

confidence: 99%

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Isotretinoin is a Safety Therapy on Kidney: A Retrospective Study

Parlak¹,

Ünal²,

Aksoy³

2018

tdd

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Objective: Isotretinoin is widely used in severe acne treatment. The drug leads to several adverse effects; skin and mucous membranes are frequently affected. It may also cause serious and fatal adverse effects like kidney damage. The aim of this study is to determine the safety of isotretinoin usage on kidney functions in patients with acne vulgaris. Methods: Eighty six patients with severe acne vulgaris and receiving 0.5 mg/kg/day of isotretinoin treatment were included in the study and evaluated retrospectively. Serum urea, creatinine, complete blood count, aspartate aminotransferase, alanine aminotransferase, lipid profile datas were obtained from patient files. Glomerular filtration rate (GFR) was measured at the baseline of treatment, 3 rd and 6 th months of treatment. Results: We detected significant increases in levels of creatinine on the third month (p=0.041), but it was not clinically significant, and there was no significant difference in creatinine levels at 6 th month. There were no significant differences among the baseline, 3 rd month (p=0.066) and 6 th month (p=0.429) of GFR values. Conclusion:We think that isotretinoin is safe for the kidneys but patients with high creatinine levels at the baseline of treatment should be closely followed up.Amaç: Şiddetli akne tedavisinde isotretinoin yaygın olarak kullanılmaktadır. İlaç çok sayıda yan etki oluşturmaktadır; deri ve mukoz membranlar ise sıklıkla etkilenmektedir. Ayrıca böbrek hasarı gibi ciddi ve ölümcül yan etkiler de görülebilmektedir. Bu çalışmanın amacı, akne vulgarisli hastalarda isotretinoin kullanımının böbrek fonksiyonları üzerindeki güvenilirliğini değerlendirmektir. Yöntemler: Şiddetli aknesi olan ve 0,5 mg/kg/gün isotretinoin tedavisi alan 86 hasta çalışmaya alındı ve geriye dönük değerlendirildi. Serum üre, kreatinin, tam kan sayımı, aspartat aminotransferaz, alanin aminotransferaz, lipit profil verileri hasta dosyalarından elde edildi. Glomerüler filtrasyon hızı (GFR) tedavi başlangıcında, tedavinin 3. ve 6. ayında hesaplandı. Bulgular: Tedavinin 3. ayında kreatinin değerlerinde anlamlı artış gözlendi (p=0,041); ancak klinik olarak anlamlı değildi, tedavinin 6. ayında ise kreatinin değerlerinde anlamlı farklılık yoktu. Başlangıç, 3. ay (p=0,066) ve 6. ay (p=0,429) GFR değerleri arasında anlamlı farklılık görülmedi. Sonuç: İsotretinoinin böbrekler için güvenilir olduğunu düşünüyoruz; ancak tedavi başlangıcında kreatin değeri yüksek olan hastalar yakın takip edilmelidir. Anahtar kelimeler: İsotretinoin, akne vulgaris, kreatinin, üre, böbrek fonksiyonu, böbrek hastalığında diyet modifikasyonu Öz

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Standardized laboratory monitoring with use of isotretinoin in acne

Cited by 72 publications

References 18 publications

Oral Isotretinoin and its Association with Liver Functions and Cholesterol Level among Acne Patients

Oral Isotretinoin and its Association with Liver Functions and Cholesterol Level among Acne Patients

The effects of isotretinoin therapy on the biliary system

Isotretinoin is a Safety Therapy on Kidney: A Retrospective Study

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