title: Association between long-term acitretin therapy and osteoporosis: no evidence of increased risk.
abstract: Osteoporosis has been observed with chronic hypervitaminosis A, leading some authors to hypothesize that systemic retinoids may have an effect on bone mineral density. Two previous small studies identified osteoporosis in patients who received long-term therapy with etretinate. Etretinate has now been superceeded by acitretin in clinical use. We hypothesized that bone mineral density is lower in patients taking long-term acitretin than control cases who had never taken acitretin. Thirty Caucasian patients receiving acitretin for a median of 3.6 years for a variety of dermatoses were studied. Bone mineral density measurements were determined using DEXA scanning at two standard sites, the lumbar spine and Ward's triangle. We did not find an association between daily dose of acitretin, total dose administered or overall duration of treatment and risk of osteopenia or osteoporosis. Acitretin appears to be safe for long-term use in patients with chronic dermatoses.
authors.affiliation: Department of Dermatology, The Royal Victoria Hospital, and Department of Epidemiology and Public Health, Queen's University of Belfast, Belfast UK. meames@doctors.org.uk
authors.forename: E A
authors.initials: EA
authors.lastname: McMullen
authors.forename: P
authors.initials: P
authors.lastname: McCarron
authors.forename: A D
authors.initials: AD
authors.lastname: Irvine
authors.forename: O M
authors.initials: OM
authors.lastname: Dolan
authors.forename: G E
authors.initials: GE
authors.lastname: Allen
authors.forename: D
authors.initials: D
authors.lastname: Irvine
mesh_terms: D015502:Absorptiometry, Photon; D017255:Acitretin / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000187:drug effects; D002908:Chronic Disease; D004334:Drug Administration Schedule; D005260:Female; D005272:Femur Neck / Q000502:physiology; D006801:Humans; D007641:Keratolytic Agents / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced*; D018570:Risk Assessment; D012871:Skin Diseases / Q000188:drug therapy*
chemical_list: D007641:Keratolytic Agents; D017255:Acitretin