The effectiveness of intermittent isotretinoin treatment in mild or moderate acne

Kaymak, Yeşim; İlter, Nilsel

doi:10.1111/j.1468-3083.2006.01784.x

Cited by 42 publications

(55 citation statements)

References 26 publications

(29 reference statements)

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“…The effectiveness of ISO treatment diminished [8,9] in line with hormonal changes in the intermittent-dose group, which suggests that a cumulative dose of ISO may be important for these hormonal changes. These changes in various hormone systems may be one of the mechanisms of action of ISO treatment.…”

Section: Discussionmentioning

confidence: 71%

“…There are a lot of different low-dose regimens used in literature, such as daily, intermittent therapy, alternate-day therapy or gradually increasing the daily dose. In these treatment modalities, the mostly frequently used dose of ISO is 0.5 mg/kg/day [4,5,6,7,8,9,10]. In intermittent-dose regimens, the treatment dose is 0.5-1 mg/kg/day; the patients are exposed to a lower cumulative dose, and the medications are not taken every day.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Different Doses of Isotretinoin on Pituitary Hormones

Karadağ¹,

Takçı²,

Ertuğrul³

et al. 2015

Dermatology

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Background: There are a limited number of studies investigating the side effects and effectiveness of various doses of isotretinoin (ISO). We have previously shown that high-dose ISO affects pituitary hormones. Objectives: To our knowledge, there is no study in the literature looking into the effects of various doses of ISO on pituitary hormones. We searched pituitary hormones in three groups of different doses in acne patients. Methods: We included 105 acne vulgaris patients from two different centers. We divided the patients into three groups; the first group received 0.5-1 mg/kg/day, the second 0.2-0.5 mg/kg/day and the third intermittent 0.5-1 mg/kg/day (only 1 week in 1 month) ISO treatment. Blood samples were collected for biochemistry and hormone analysis, before the treatment and after 3 months. Results: After 3 months of treatment with ISO, luteinizing hormone (LH) (p < 0.001), prolactin (p < 0.001), total testosterone (p < 0.001), adrenocorticotropic hormone (ACTH) (p < 0.001), cortisol (p < 0.001), insulin-like growth factor-binding protein 3 (p < 0.001), insulin-like growth factor 1 (IGF-1) (p = 0.002), growth hormone (GH) (p = 0.002) and free T3 (fT3) (p < 0.001) levels had decreased significantly. Furthermore, we split data into three different groups. Among the patients receiving intermittent-dose ISO, LH, ACTH, IGF-1, GH and fT3 measurements lost significance. Most of the significant measurements observed in the whole group were also significant among the patients receiving high-dose ISO. Additionally, dehydroepiandrosterone sulfate (p = 0.003) levels increased, and free T4 levels decreased significantly. Conclusions: ISO affects pituitary hormones at all of these three doses. The differences in pituitary hormones are more pronounced in high-dose treatment. The weakest effect was observed in the intermittent-dose group. Choosing lower doses of ISO may decrease side effects, however the effectiveness of the treatment may also be diminished. ISO, by affecting the PPARγ/RXR system, may affecting hormone systems. These changes in various hormone systems may be related to the effectiveness of ISO.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

The Effect of Different Doses of Isotretinoin on Pituitary Hormones

Karadağ¹,

Takçı²,

Ertuğrul³

et al. 2015

Dermatology

View full text Add to dashboard Cite

show abstract

“…Kaymark and Ilter evaluated 60 patients, 34 women and 26 men, between 18 and 33 years of age [8]. These individuals had discrete-to-moderate acne located on the face.…”

Section: Material Methods and Resultsmentioning

confidence: 99%

“…Moderate cases received 0.6-0.75 mg/kg/day and mild cases received 0.5 mg/kg/day [8]. Some 41 (68.3%) of the 60 patients completed the treatment.…”

Section: Affiliationsmentioning

confidence: 96%

Oral isotretinoin: intermittent and low-dosage regimen in acne

Ramos‐e‐Silva

Carneiro

2007

Expert Review of Dermatology

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Evaluation of: Kaymak Y, Ilter N. The effectiveness of intermittent isotretinoin treatment in mild or moderate acne.Acne is a chronic disease of the pilosebaceous follicle that affects primarily adolescents. It can be safely treated today and the physician must be aware of the main possible therapies, avoiding the treatment of discrete acne with strong systemic drugs and of severe acne with only mild local medication. Oral isotretinoin is one drug that is used successfully for some forms of acne but its optimum dose and ideal therapeutic scheme are still under discussion. Kaymak and Ilter present an intermittent and low-dose regimen, which is very interesting since it may decrease the adverse reactions, while maintaining its high efficacy.

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“…Kaymak and Ilter [11] showed the efficacy of the intermittent regimen (0.5-0.75 mg/kg daily for 1 week out of every 4 weeks for a total period of 6 months) in the treatment of 60 patients with mild-to-moderate acne. Amichai et al [12] reported successful treatment of 638 patients with moderate acne with low-dose regimen (0.3-0.4 mg/kg daily for a total period of 6 months).…”

Section: Resultsmentioning

confidence: 99%

A randomized, open-label, comparative study of efficacy of low-dose continuous versus low-dose intermittent oral isotretinoin therapy in moderate-to-severe acne vulgaris

Shetti¹,

Hn²,

Hanumantharaya³

2017

Natl J Physiol Pharm Pharmacol

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Background: Acne vulgaris is a chronic inflammatory disease of pilosebaceous units. Oral isotretinoin is recommended for patients with moderate-to-severe acne vulgaris who are not responding satisfactorily to conventional therapies. Recent reports indicate that acne patients have been benefiting from the low-dose treatment protocols. Aims and Objectives: The aim of this study was to assess and compare the efficacy of oral isotretinoin in low-dose continuous and intermittent treatment of moderate-to-severe acne vulgaris. Materials and Methods: This was a prospective, randomized, open-labeled, comparative, efficacy study carried out at Outpatient Clinic in the Department of Dermatology in Mandya Institute of Medical Sciences, Mandya. Out of 120 patients screened, 100 patients were selected. Patients with moderate-to-severe acne were assigned equally (50 patients each) to one of the two treatment regimens using block randomization technique, Group A was given lowdose continuous regimen -20 mg of oral isotretinoin once daily for 4 months and Group B was given low-dose intermittent regimen -20 mg of oral isotretinoin once daily for 1 week out of every 4 weeks. The patients were followed up every 4 th week during the treatment period. A 6-month follow-up evaluation after the end of treatment was performed. The outcome of the therapy was based on the improvement in the global acne grading system (GAGS) score and patients' satisfaction with the treatment in the 4-point scale. Results: This study showed statistically significant clinical improvement and difference in GAGS score between Group A and Group B (P < 0.005). Conclusion: This study suggests that, considering clinical efficacy, low-dose continuous treatment is most suitable for patients with moderate-to-severe acne vulgaris.

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The effectiveness of intermittent isotretinoin treatment in mild or moderate acne

Abstract: Intermittent isotretinoin treatment was found to be a safe and effective choice for patients with mild or moderate acne.

Cited by 42 publications

References 26 publications

The Effect of Different Doses of Isotretinoin on Pituitary Hormones

The Effect of Different Doses of Isotretinoin on Pituitary Hormones

Oral isotretinoin: intermittent and low-dosage regimen in acne

A randomized, open-label, comparative study of efficacy of low-dose continuous versus low-dose intermittent oral isotretinoin therapy in moderate-to-severe acne vulgaris

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