Risk factors promote elevations of serum lipids in acne patients under oral 13-cis retinoic acid (isotretinoin) (original) (raw)
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Evaluation of Lipid profile levels in acne vulgaris on low dose isotretinoin: A prospective study
IP Innovative Publication Pvt. Ltd., 2017
Aim: The present study is to assess the effect on the variations of total cholesterol, triglycerides, HDL cholesterol and LDL cholesterol in patients with acne vulgaris on low dose isotretinoin treatment. Materials and Method: A total of fifty patients diagnosed having moderate to severe acne with the age group of 15-45yrs attending dermatology department, was treated with 20mg of isotretinoin daily for 4 months. Blood Samples were collected on day 0, 2nd wk, 1month, 2month, 3month and 4month. Result: Measured baseline values of cholesterol in continuous therapy group 116.86 ± 23.55, then after at 4wks, 8wk, 12wk, 16wk and at the end of the treatment were increased above the baseline values at every interval. Significant P-value is obtained when compared with the baseline. There was statistically significant increase in cholesterol, triglycerides, LDL at all the intervals compared with baseline and above normal limit with significant decrease in HDL levels. Conclusion: Low dose continuous isotretinoin therapy caused increase in cholesterol, triglycerides, LDL above the normal range with grade 1 increase and decrease in HDL levels. Side effects were mild and well tolerated and did not need termination of the treatment. However it is important to educate about the consequences. We advise our specialist that the usage of low dose isotretinoin in moderate to severe acne can be done with minimal concern but close follow up is important.
Effects of isotretinoin on serum vitamin E levels in patients with acne
International Journal of Dermatology, 2013
Anecdotal reports suggest that using retinoids with vitamin E leads to improvements of some side effects due to isotretinoin. However, vitamin E blood levels have not been reported previously in patients with acne treated with isotretinoin. We aimed to investigate the serum vitamin E levels before and after isotretinoin therapy in patients with acne. A total of 70 patients treated with isotretinoin for acne in our dermatology department were included in this study. The serum vitamin E levels were measured as baseline before isotretinoin treatment. All patients received 0.6-0.8 mg/kg/d isotretinoin. The treatment was finished within 5-7 months while ensuring that the cumulative dose was 120 mg/kg. Serum vitamin E levels were measured again in the last month of treatment. The mean serum vitamin E levels before and after treatment were compared. Forty-six patients completed the study. It was detected that the mean serum vitamin E level was 20.22 mg/dl before isotretinoin treatment. In the last month of treatment, the mean serum vitamin E level was 16.24 mg/dl. Serum vitamin E levels decreased in all patients except three. The mean serum vitamin E level after treatment was statistically decreased in comparison with the mean serum vitamin E level before treatment. Our results showed that vitamin E levels decreased during isotretinoin treatment. We considered that some of the side effects due to isotretinoin treatment might be related to this, and supplementation vitamin E may be useful during isotretinoin treatment.
Archives for Dermatological Research
Isotretinoin treatment alters the plasma lipid levels but the mechanisms and the effects on the metabolism of triglyceride-rich lipoproteins such as chylomicrons and very-low-density lipoproteins remain unclear. We investigated the effect of isotretinoin on the plasma kinetics of emulsion models of triglyceride-rich lipoproteins and the lipid profile. Ten patients with acne were treated with 0.8 mg/kg of isotretinoin over 4 weeks for comparison with non-treated acne patients. In both groups the plasma kinetic study of a triglyceride-rich emulsion double-labeled with 14 C-cholesterol oleate and 3 H-triolein was performed after intravenous injection of the emulsion and radioactive counting in plasma samples collected over 60 min. Patients using isotretinoin showed decreased removal from the plasma of the 3 H-triglyceride (median 0.019 min-1 TG) compared with controls (median 0.044 min À1 , P=0.007), and the removal of the emulsion 14 C-cholesterol oleate also tended to be decreased (treatment: 0.011 min À1 ; controls: 0.024 min À1 , P=0.06). The values of total and LDL cholesterol and triglycerides were increased posttreatment (P<0.03). In conclusion, while increasing the fasting plasma concentration of VLDL and LDL, which are traditional risk factors for atherosclerosis, isotretinoin treatment also slows down the metabolism of triglyceride-rich lipoproteins such as chylomicrons, as tested by the emulsion model, an effect that is also increasingly recognized as atherogenic.
Diabetes/Metabolism Research and Reviews, 2001
Background 13-cis-Retinoic acid (Roaccutan 1) treatment is associated with disturbances in lipid and sometimes also in glucose metabolism. Thus, we investigated whether 13-cis-retinoic acid treatment decreases insulin sensitivity. Methods We studied 11 men [aged 24t2 years (meantSEM), body mass index (BMI) 22.1t0.9 kg/m 2 ] who received Roaccutan 1 treatment for acne for a period averaging 5 months but who were otherwise healthy. The insulin sensitivity of the subjects was measured before, during and 1-3 months after the end of treatment using the euglycaemic hyperinsulinaemic clamp technique. Results Treatment with 13-cis-retinoic acid reduced total (59t4 vs 55t4 mmol/kg/min, p<0.02), oxidative (25t1 vs 22t2 mmol/kg/min, p<0.05) and non-oxidative (36t3 vs 33t3 mmol/kg/min, p=0.05) glucose disposal rate, and there was a 4% increase in HbA 1c (from 5.2t0.07 to 5.4t0.07%, p<0.02). After treatment cessation these values returned to baseline. 13-cis-Retinoic acid treatment also resulted in increased very low density lipoprotein (VLDL) and low density lipoprotein (LDL) cholesterol, increased VLDL triglyceride, and increased VLDL and LDL phospholipid concentrations. Conclusion Treatment of acne with 13-cis-retinoic acid reduces insulin sensitivity and induces alterations in lipid metabolism resembling those of the insulin resistance syndrome.
1996
Purpose: e purpose of this study was to investigate the e ect of oral isotretinoin, a drug used in the treatment of acne vulgaris, on hearing function determined by serial audiology examinations. Methods: Forty patients with acne vulgaris were included in this study. Nine patients were excluded from the study because of inconsistent follow-up. e hearing of each participant was tested with pure tone audiometry and transient evoked autoacoustic emissions before and two and four weeks a er treatment with isotretinoin (0.3-0.6 mg/kg/day) in the remaining 31 patients (62 ears). Results: e di erences between the mean values of the pre-treatment and post-treatment pure tone hearing thresholds at 1000, 2000, 4000 and 6000 Hz frequencies were statistically signi cant (p<0.05), but there was no signi cant di erence between the pretreatment and post-treatment values at 250 and 500 Hz frequencies (p>0.05). e di erence between the pre-treatment and post-treatment signal-noise ratio values of the transient evoked autoacoustic emissions was not signi cantly di erent (p>0.05). Conclusion: Our results suggest that the use of isotretinoin may cause bilateral hearing threshold changes. Further animal and human studies are required to investigate and characterize isotretinoin-induced neurophysiological alterations in hearing.
Treatment outcome of acne vulgaris with oral isotretinoin
JCPSP, Journal of the …, 2009
Objective: To determine the clinical efficacy of oral isotretinoin in the treatment of severe acne and assess its effect on total serum cholesterol, triglycerides, HDL-cholesterol and Low-Density Lipoprotein-cholesterol (LDL-cholesterol). Study Design: A cohort, descriptive, hospital-...
13-cis-Retinoic Acid: It’s Therapeutic Implications and Adverse Effects
Journal of Skin Care Research and Reports
Isotretinoin (13-cis-retinoic acid) is a second-generation synthetic retinoic acid analog beneficial for the treatment of recalcitrant nodulocystic acne. The 13-cis-retinoic acid is also used to treat oral leukoplakia and has shown mixed results in cancer therapy. It is a much safer drug but can cause severe side effects like teratogenicity, dryness of the skin (including eyes, tongue, mouth, and nasal mucosa), rashes on the face and body, itching, increased photosensitivity, bleeding from the nose (epistaxis), lip inflammation (cheilitis), bleeding & inflammation of gums (gingivitis), and depression & suicidal ideation in patients. It is a schedule H drug and is contraindicated in pregnant women. This review article gives a complete understanding of the pharmacology of Isotretinoin along with the completed clinical trials and research on Isotretinoin for treating other diseases apart from acne and oral leukoplakia. The article also deals in measures to prevent the adverse effects related to 13-cis-retinoic acid.
Oral Vitamin A for Acne Management: A Possible Substitute for Isotretinoin
Journal of Drugs in Dermatology
for acne underwent clinical trials until isotretinoin was approved in 1982. We examined the published literature on the use of vitamin A from 1934-2021 using the databases PubMed and Google Scholar to assess its ability to serve as an alternative to isotretinoin for patients with acne. Nine studies (8 clinical trials and one case study) were included after evaluation for relevancy to the topic of interest. Of the 9 trials reviewed, 8 had improvement in patients' acne using vitamin A (Table 1). Treatment doses ranged from 36,000 IU daily to 500,000 IU daily. 4-12 Forty-four percent of trials used 100,000 IU daily with success. Treatment lengths ranged from one month to seven months. Mean duration until clinical improvement ranged from 7 weeks to 4 months after initiation of therapy. Relapse was noted in 33% of the trials included, however, this is comparable to the relapse rates (13-42%) noted for isotretinoin. In the clinical trials reviewed for both vitamin A and isotretinoin, the most frequent side effects were mucocutaneous, such as cheilitis and xerosis. At doses of 500,000 IU daily, mucocutaneous side effects were more severe, however, no serious side effects were noted. Benign elevations
Actas dermo-sifiliográficas, 2015
The high rate of relapse of acne lesions following oral isotretinoin treatment is a common problem which remains unsolved. To avoid or minimize relapses, topical retinoids have been used for many years as maintenance treatment. However, adverse effects frequently occur. To determine the efficacy and safety of a new retinoid combination (Retinsphere technology) in maintaining post-treatment response to oral isotretinoin. Prospective, randomized, double-blind and vehicle-controlled study of 30 patients with acne previously treated with isotretinoin. Treatment with the retinoid combination was applied to one side of the face and vehicle was applied to the other, once daily, for 3 months. Standardized photographs were taken using RBX technology at baseline, 1.5 months and 3 months. The primary efficacy endpoint was the appearance of relapse on the treated side compared to the vehicle-treated side. Other endpoints included lesion count, investigator-reported improvement, patient-reported...
Dermatology Research and Practice
Background. Acne vulgaris is an inflammatory disease of pilosebaceous units which may cause permanent dyspigmentation and/or scars if not treated. Isotretinoin is recommended in the treatment of recalcitrant or severe acne, but it is associated with common adverse effects that frequently result in patients incompliance and discontinuation of the drug. The present study was designed to assess the efficacy of oral omega-3 in decreasing the adverse effects of isotretinoin. Materials and Methods. In this randomized double-blind clinical trial, a total of 118 patients with moderate or severe acne were randomly divided into two (case and control) groups. The control group was treated with isotretinoin 0.5 mg/kg, and the case group was treated with the same dose of isotretinoin combined with oral omega-3 (1 g/day). The treatment was lasted for 16 weeks and mucocutaneous side effects of isotretinoin were recorded and compared between the two groups in weeks 4, 8, 12, and 16. Results. Cheili...