Analysis of laboratory data in acne patients treated with isotretinoin: is there really a need to perform routine laboratory tests?
BACKGROUND
Isotretinoin has been used to treat acne since 1982. Its current indications in the package insert are limited and many physicians still feel uncomfortable prescribing it because of its side effects. Serum levels of liver enzymes and lipids are carried out as a routine in most clinics both before and during treatment.


OBJECTIVE
Our objective was to evaluate the effect of isotretinoin on serum lipids, liver function and other laboratory parameters in order to assess the necessity to perform routine laboratory tests.


METHODS
Computerized medical files of 1292 patients in private practice that received isotretinoin for acne were analyzed.


RESULTS
907 patients completed a treatment course of 5 to 9 months. Serum levels of liver enzymes were not elevated to a degree necessitating discontinuation of treatment. Only 1.5% of the patients had serum triglyceride levels above 400 mg%. No laboratory abnormalities were a cause for discontinuation of treatment. During a 6-year follow up only 3.5% of patients received a second course of therapy with isotretinoin.


CONCLUSIONS
Aside from its teratogenic effect, isotretinoin is a safe and excellent drug for acne therapy. It should be prescribed for any inflammatory acne and in our opinion there is no need for a routine laboratory follow-up in young, healthy patients aside from a pregnancy test in females. At present, isotretinoin should be considered as the drug of choice for moderate to severe acne.
Alcalay
J
J
Private Practice, Maccabi Health Services, Tel Aviv, Israel. alcalays@.inter.net.il
Landau
M
M
Zucker
A
A
D000152:Acne Vulgaris / Q000097:blood* / Q000188:drug therapy*; D000293:Adolescent; D000328:Adult; D001774:Blood Chemical Analysis; D003955:Diagnostic Tests, Routine / Q000592:standards; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage / Q000009:adverse effects*; D007641:Keratolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D008055:Lipids / Q000097:blood; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D012189:Retrospective Studies
D007641:Keratolytic Agents; D008055:Lipids; D015474:Isotretinoin