Isotretinoin: controversies, facts, and recommendations

被引:28
作者
Bauer, Lindsey B. [1 ,5 ]
Ornelas, Jennifer N. [2 ,6 ]
Elston, Dirk M. [3 ]
Alikhan, Ali [4 ]
机构
[1] Univ Missouri, Sch Med, Columbia, MO 65211 USA
[2] Univ Calif Davis, Sch Med, Sacramento, CA 95817 USA
[3] Med Univ South Carolina, Dept Dermatol, 171 Ashley Ave, Charleston, SC 29425 USA
[4] Univ Cincinnati, Coll Med, Dept Dermatol, Cincinnati, OH USA
[5] St Marys Hosp, Dept Internal Med, St Louis, MO 63101 USA
[6] Wake Forest Baptist Med Ctr, Dept Internal Med, Winston Salem, NC USA
关键词
Acne; isotretinoin; accutane; inflammatory bowel disease; depression; hypertriglyceridemia; iPLEDGE; transaminitis; INFLAMMATORY-BOWEL-DISEASE; 13-CIS RETINOIC ACID; QUALITY-OF-LIFE; GROWTH-FACTOR-I; ACNE-VULGARIS; ORAL ISOTRETINOIN; PREGNANCY PREVENTION; PLASMA-LIPIDS; MOOD CHANGES; CYSTIC ACNE;
D O I
10.1080/17512433.2016.1213629
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Introduction: Since it was introduced to the market by Hoffman-La Roche (Roche) in 1982, isotretinoin has remained the most effective treatment for severe and recalcitrant acne. However, it has also been surrounded by controversy due to its teratogenicity and inconsistent associations with depression, suicidality, inflammatory bowel disease, increases in lipid levels, and elevated transaminases. Areas covered: In this article, we reviewed data regarding safety of isotretinoin and its association with these conditions. A thorough and comprehensive search on the topics was performed using pubmed and google scholar. Expert commentary: Despite common misperceptions, there is weak evidence for increased incidence of depression, suicidality, or inflammatory bowel disease with isotretinoin use. Furthermore, data indicates that transient increases in transaminases and lipid levels do not typically necessitate discontinuation of therapy. We hope to provide clinicians with information necessary to have meaningful discussions with patients regarding the safety and efficacy of isotretinoin.
引用
收藏
页码:1435 / 1442
页数:8
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