A proposed set of new guidelines for routine blood tests during isotretinoin therapy for acne vulgaris.
BACKGROUND
Isotretinoin has been proven to be an effective treatment for acne vulgaris. The enclosed package insert with isotretinoin suggests weekly/biweekly laboratory testing (hepatic functions and lipid analysis) but fails to recommend the needed action levels for abnormalities.


METHODS
We provide a statistical analysis of a retrospective study of 141 individuals' course of therapy on isotretinoin and their laboratory blood analysis results.


RESULTS
Very few statistically significant elevations in liver enzymes or lipid profiles occurred. More importantly, in only 1 case did these elevations warrant the discontinuation of therapy.


CONCLUSIONS
The data presented here support the conclusion that limited blood testing should be performed for most patients and that more complete blood testing be done only for those patients with a significant response in liver enzymes, cholesterol or triglycerides. A set of guidelines is proposed for the practicing physician to interpret blood test results.
Altman
Rachel S
RS
University of Medicine and Dentistry, Newark, N.J., USA. altmanra@umdnj.edu
Altman
Lawrence J
LJ
Altman
Jeffrey S
JS
D000152:Acne Vulgaris / Q000097:blood / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D001774:Blood Chemical Analysis; D002648:Child; D002784:Cholesterol / Q000097:blood*; D003955:Diagnostic Tests, Routine / Q000592:standards; D004334:Drug Administration Schedule; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014280:Triglycerides / Q000097:blood*
D014280:Triglycerides; D002784:Cholesterol; D015474:Isotretinoin