The safety of isotretinoin treatment in patients
with bone fractures

Miziołek, Bartosz; Bergler‐Czop, Beata; Stańkowska, Anna; Brzeźińska-Wcisło, Ligia

doi:10.5114/ada.2019.82822

Cited by 19 publications

(21 citation statements)

References 54 publications

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“…Miziolek et al indicated that excessive intake of vitamin A may deteriorate functioning of vitamin D especially in subjects with a vitamin D deficiency (<50 nmol/l of 25 OH vitamin D), therefore a similar side effect may also appear in patients using ISO. The authors suggested that decreasing the use of ISO after bone injury or continuing the treatment at low dose with a concomitant correction of vitamin D and calcium status 30 . The vitamin D deficiency may be a condition predisposing to osteoporosis and decreased bone mineral density 31 .…”

Section: Discussionmentioning

confidence: 99%

Effect of Serum 25 Hydroxy Vitamin D Level on Isotretinoin-Induced Musculoskeletal Symptoms: A Cross-Sectional Study

Mülkoğlu

Karaosmanoğlu

2020

Sci Rep

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Isotretinoin (ISO) is a drug which is used for the treatment of severe and refractory acne vulgaris (AV), over the last few decades. The drug has various musculoskeletal side effects. The aim of this study was to investigate relationship between serum 25 hydroxy (OH) vitamin D levels and the ISOinduced musculoskeletal side effects in patients with AV. We included 87 patients receiving ISO and had musculoskeletal symptoms as adverse effect (AE) group. Another 90 patients receiving ISO for AV and had any musculoskeletal complaints were recruited as control (C) group. Locomotor system examination of the patients was performed by the same clinician. Serum 25 OH vitamin D levels of the all participants were measured. Patients in the AE group were divided into three subgroups by serum 25 OH vitamin D levels. Patients with serum 25 OH vitamin D level lower than 10 ng/ml was classified as Group I, the ones between 10-20 ng/ml as Group II and those higher than 20 ng/ml were classified as Group III. AE and C groups were similar in terms of age and sex (p > 0.05). There was no statistically significant difference in the mean serum vitamin D levels between two groups (p = 0.17). Also, there was no significant difference in number of arthralgia (p = 0.30), myalgia (p = 0.29), low back pain (p = 0.10) and sacroiliitis (p = 0.17) between three subgroups in AE group. In addition, we found no statistically significant correlation between the serum vitamin D levels and age, cumulative dose of ISO, arthralgia, myalgia and sacroiliitis parameters in AE group (p > 0.05). Serum 25 OH vitamin D levels between the AE and C groups were similar. We also found that no significant difference in musculoskeletal adverse events between AE subgroups. Therefore, it can be concluded that vitamin D deficiency has no effect on the musculoskeletal adverse events in patients receiving ISO.

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Section: Discussionmentioning

confidence: 99%

Effect of Serum 25 Hydroxy Vitamin D Level on Isotretinoin-Induced Musculoskeletal Symptoms: A Cross-Sectional Study

Mülkoğlu

Karaosmanoğlu

2020

Sci Rep

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“…Experts recommend to stop isotretinoin treatment or at least to reduce the treating dose to 0.5 mg/kg daily (low‐dose isotretinoin), together with correction of Vitamin D and calcium status is suggested to avoid isotretinoin‐induced osteoporosis (Miziołek, Bergler‐Czop, Stańkowska, & Brzezińska‐Wcisło, ). On the other hand, isotretinoin may induce acute rhabdomyolysis that have a negative effect on long bone healing due to muscle weakness particularly muscle flaps in surrounding of the fracture.…”

Section: Safety Of Low‐dose Isotretinoinmentioning

confidence: 99%

Low dose of isotretinoin: A comprehensive review

Abdelmaksoud

Lotti

Anadolu

et al. 2020

Dermatologic Therapy

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Isotretinoin is a first‐generation retinoid initially approved for the treatment of severe cases of acne vulgaris (nodulocystic acne). Because of its broad anti‐inflammatory and immunomodulatory properties, it has been used beyond its initial approval in a myriad of other indications. Adverse effects of isotretinoin vary from xerosis to teratogenicity. Herein, we reviewed the literature, through date‐unlimited PubMed search, from inception till December 2019, using the following search terms: “low‐dose isotretinoin” and “dermatology,” “isotretinoin and safety,” “isotretinoin, off‐label uses,” “isotretinoin and male fertility,” “isotretinoin, iPLEDGE system,” aiming to deliver a therapeutic update relevant to clinical practice. All English‐language articles were considered with no limitation based on the articles' type. Low‐dose isotretinoin is not limited to old and novel dermatological conditions, but also showed promising results in the field of infertility and safety in the field of gastroenterology. We also highlight on the safety profile of the drug and experts' recommendations to enhance safety measures to decrease fetal risk while on isotretinoin.

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“…Os autores relataram casos de ossificação semelhante à observada na Hiperostose Esquelética Idiopática Difusa (do inglês: Diffuse idiopathic skeletal hyperostosis, DISH), fechamento prematuro de epífises e afinamento periosteal, hipercalcemia e osteoporose como reações adversas ao uso da isotretinoina (33). Outro grupo demonstrou o aumento do risco de fraturas deflagrado pela isotetinoina, como consequência do aumento da formação de osteoclastos, responsáveis pela reabsorção óssea e, por conseguinte, pela diminuição da massa óssea cortical (34).…”

Section: Retinoides Na Cicatrização óSseaunclassified

Isotretinoina: Possível Interferência na Cicatrização Pós-Exodontia

Cordeiro

Bittencourt

Júnior

et al. 2020

Rev. Naval de Odontologia

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A farmacovigilância é definida como "a ciência e atividades relativas à identificação, avaliação, compreensão e prevenção de efeitos adversos ou quaisquer problemas relacionados ao uso de medicamentos". Os medicamentos têm tanto o potencial de trazer benefícios quanto o de causar danos. O ácido 13-cis-Retinoico ou isotretinoina é um retinoide antiacne de referência no tratamento de doenças dermatológicas não responsivas a terapias convencionais, como a acne cística severa. Os efeitos adversos descritos na bula do medicamento implicam alterações em vários sistemas do corpo humano. Aqueles relacionados ao tecido ósseo, como a calcificação dos ligamentos e tendões, a redução na densidade óssea, o fechamento epifisário e hipercalcemia, possuem maior relevância na odontologia, levantando a hipótese para possível interferência na cicatrização dos alvéolos, após exodontia. Este ar tigo teve por objetivo realizar uma revisão de literatura reunindo informações sobre a possibilidade de interferência da isotretinoina em cirurgias maxilofaciais. Apesar da escassez de dados científicos conclusivos sobre a interferência da isotretinoína na cicatrização alveolar em humanos, estudos recentes sobre as vias de sinalização dos retinoides abrem novas perspectivas de pesquisa na influência dos retinoides no tecido ósseo alveolar. Esta possibilidade reforça a impor tância de uma atualização sobre os efeitos adversos da isotretinoína, bem como da anamnese criteriosa em pacientes com histórico de acne severa a fim de evitar complicações.

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The safety of isotretinoin treatment in patients with bone fractures

Cited by 19 publications

References 54 publications

Effect of Serum 25 Hydroxy Vitamin D Level on Isotretinoin-Induced Musculoskeletal Symptoms: A Cross-Sectional Study

Effect of Serum 25 Hydroxy Vitamin D Level on Isotretinoin-Induced Musculoskeletal Symptoms: A Cross-Sectional Study

Low dose of isotretinoin: A comprehensive review

Isotretinoina: Possível Interferência na Cicatrização Pós-Exodontia

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