Monitoring Serum Lipid Profile and Liver Transaminase Levels During Isotretinoin Therapy
Monitoring Serum Lipid Profile and Liver Transaminase Levels During Isotretinoin Therapy
Objective: Isotretinoin is generally chosen as the first line treatment of nodulocystic acne. Close laboratory monitoring is a general practice for many dermatologists to be on the safe side due to the laboratory side effects of isotretinoin. We aimed to determine the laboratory side effects of oral isotretinoin and optimal frequency interval for laboratory monitoring during isotretinoin treatment. Materials and Methods: One hundred patients who were under oral isotretinoin therapy were included in the study; serum lipid levels along with liver transaminase levels were recorded at the baseline, 1-, 3- and 6- months of the therapy. Results: We found that there might be slight elevations in serum aspartate transaminase and lipid levels during isotretinoin therapy (p
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- [1] Macek C. Synthetic vitamin A analogue (isotretinoin) awaiting approval for cystic acne therapy. JAMA. 1982;247:1800-1801.
- [2] Lee YH, Scharnitz TP, Muscat J, Chen A, Gupta-Elera G, Kirby JS. Laboratory Monitoring During Isotretinoin Therapy for Acne: A Systematic Review and Meta-analysis. JAMA Dermatol. 2016;152:35-44.
- [3] Landis MN. Optimizing Isotretinoin Treatment of Acne: Update on Current Recommendations for Monitoring, Dosing, Safety, Adverse Effects, Compliance, and Outcomes. Am J Clin Dermatol. 2020;21:411-419.
- [4] Hansen TJ, Lucking S, Miller JJ, Kirby JS, Thiboutot DM, Zaenglein AL. Standardized laboratory monitoring with use of isotretinoin in acne. J Am Acad Dermatol. 2016;75:323-8.
- [5] Landau M, Mesterman R, Ophir J, Mevorah B, Alcalay J, Harel A, Nevo Y.Clinical significance of markedly elevated serum creatine kinase levels in patients with acne on isotretinoin. Acta Derm Venereol. 2001;81:350-2.
- [6] Marson JW, Baldwin HE.The creatine kinase conundrum: a reappraisal of the association of isotretinoin, creatine kinase, and rhabdomyolysis. Int J Dermatol. 2020;59:279- 283.
- [7] Chroni E, Monastirli A, Tsambaos D. Neuromuscular adverse effects associated with systemic retinoid dermatotherapy. Drug Safety. 2010;33:25-34.
- [8] Webster GF, Webster TG, Grimes LR. Laboratory tests in patients treated with isotretinoin: occurrence of liver and muscle abnormalities and failure of AST and ALT to predict liver abnormality. Dermatol Online J. 2017;23:13030/ qt7rv7j80p.
- [9] Barbieri JS, Shin DB, Wang S, Margolis DJ, Takeshita J. The clinical utility of laboratory monitoring during isotretinoin therapy for acne and changes to monitoring practices over time. J Am Acad Dermatol. 2020;82:72-79.
- [10] Aurousseau MH, Levacher S, Bénéton C, Blaise M, Pourriat JL. Transient dysfibrinogenemia and thrombocytopenia associated with recurrent acute pancreatitis in the course of isotretinoin therapy. Rev Med Interne. 1995;16:622-5.
- [11] Greene J. An adolescent with abdominal pain taking isotretinoin for severe acne. South Med J. 2006;99:992- 994.