Time to Change Guidelines for Laboratory Monitoring During Isotretinoin Treatment

Ben-Shoshan, Danielle; Gomolin, Arieh; Litvinov, Ivan V.; Netchiporouk, Elena

doi:10.1177/1203475419879882

Cited by 6 publications

(3 citation statements)

References 7 publications

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“…American Academy of Dermatology recommends lipid and liver profile monitoring at baseline at least once throughout therapy however, most clinicians continue to monitor laboratory measures like lipid and liver profiles and complete blood counts on a monthly basis [20]. Results of a cohort study in 2021 showed that triglyceride and liver function testing abnormalities of grade 3 or above were found in fewer than 1% and 0.5% of 1,863 patients treated with isotretinoin, respectively.…”

Section: Monitoring Of Isotretinoinmentioning

confidence: 99%

Indication, Contraindication, Complication and Monitoring of Isotretinoin

Alyamani

Alharbi²,

Alghamdi³

et al. 2022

JPRI

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Acne is the most prevalent skin disorder affecting primarily adolescents and young adults. Side effects of acne, such as scarring, dyspigmentation, and low self-esteem, can cause severe morbidity. Isotretinoin is a medication that is used to treat severe acne. The medicine was licensed by the Food and Drug Administration in 1982 to treat severe nodular acne that had been resistant to other treatments, including systemic antibiotics. Other indications of isotretinoin include moderate acne, cutaneous T-cell lymphomas, neuroblastoma, and the prevention of squamous cell carcinoma in high-risk patients. Rosacea, folliculitis, and pyoderma faciale have all been treated with isotretinoin. Some side effects are also associated with the use of isotretinoin including teratogenicity the most severe one. The purpose of this research is to review the available information about indication, contraindication, complication and monitoring of Isotretinoin. Various dermatological conditions are also treated with isotretinoin apart from the common indication of acne. Complete blood count along with the lipid profile, and liver function test are monitored in patients on isotretinoin therapy. Dry lips and dry skin are among the common side effects of isotretinoin. Due to the severe complication of teratogenicity isotretinoin is contraindicated among pregnant women. Evidence from the literature suggests that isotretinoin is the effective medication in treatment of acne and low dose of isotretinoin does not cause any complication. Evidence-based guidelines and strategies for safety and efficacy of isotretinoin can be developed by further clinical research and trials.

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Section: Monitoring Of Isotretinoinmentioning

confidence: 99%

Indication, Contraindication, Complication and Monitoring of Isotretinoin

Alyamani

Alharbi²,

Alghamdi³

et al. 2022

JPRI

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“…However, side effects such as teratogenicity, hyperlipidemia, pancreatitis, and leukopenia are possible and require periodic laboratory monitoring[ 1 - 10 ]. The 2016 laboratory monitoring guidelines in the US do not recommend routine monitoring of the complete blood cell count (CBC) during oral isotretinoin administration for acne[ 1 , 5 , 6 ]. However, the United States and European guidelines recommend monitoring serum lipid profiles and liver function enzymes[ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal laboratory testing protocol for patients with acne taking oral isotretinoin

Park¹,

Shin²,

Choi³

et al. 2023

World J Clin Cases

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BACKGROUND Isotretinoin is a widely prescribed drug for various dermatological conditions, especially acne. Blood tests are routinely performed to monitor its side effects. However, the optimal testing schedule remains controversial. AIM To evaluate the laboratory monitoring tests and schedules of patients with acne taking isotretinoin to determine the most efficient testing regimen. METHODS We retrospectively reviewed electronic medical records from the Dermatology Department of Dongguk University Ilsan Hospital from 2005 to 2020 for patients prescribed isotretinoin for acne who underwent monthly blood tests. RESULTS Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and triglyceride (TG) levels significantly changed between 5 and 6 mo when the total prescription period and dose variables were considered altogether. The high-density lipoprotein level also significantly changed between 5 and 6 mo. However, low-density lipoprotein (LDL) and total cholesterol levels significantly changed between 1 and 2 mo. CONCLUSION We recommend testing AST, ALT, and TG levels once every 5 to 6 mo. We also suggest testing LDL and total cholesterol levels during the first and second months.

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“…2,3 Given the well-documented adverse effects of systemic retinoids such as teratogenicity and hepatotoxicity, they are not recommended for cSCC prevention in the general population. 4 There is insufficient evidence for the use of topical retinoids for chemoprevention. 3 Natural vitamin A can be obtained from nutrition in the form of retinol/retinyl ester from animal sources or provitamin A carotenoids from fruits/vegetables (converted to vitamin A in the intestinal mucosa).…”

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confidence: 99%