title: Effect of a single course of isotretinoin therapy on bone mineral density in adolescent patients with severe, recalcitrant, nodular acne.
abstract: BACKGROUND
  Adverse changes in bone have been reported for patients undergoing high-dose, long-term (several years) isotretinoin therapy for disorders of cornification. The effect of short-term (4-5 months) therapy at the lower dose recommended for acne on bone development in younger, growing adolescent (12-17 years) patients has not been well studied.
  
  
  OBJECTIVE
  The purpose of the study was to evaluate the effect of a standard, single course of isotretinoin (Accutane) therapy on bone mineral density (BMD) of the lumbar spine and hip in adolescents ages 12 to 17 years with severe, recalcitrant, nodular acne.
  
  
  METHODS
  In this open-label, multicenter study, 217 adolescents (81 girls) with severe, recalcitrant, nodular acne were enrolled and treated with isotretinoin twice daily with food at the recommended total dose of approximately 1 mg/kg for 16 to 20 weeks. BMD in the lumbar spine and hip was measured at baseline and at the end of therapy by dual energy radiograph absorptiometry.
  
  
  RESULTS
  There was no clinically significant mean change in BMD measured at the lumbar spine (+1.4%, range: -4.9% to +12.3%) or total hip (-0.26%, range: -11.3% to +15.0%). Hyperostosis was not observed in any patient. Typical efficacy expected in the treatment of acne was observed.
  
  
  CONCLUSIONS
  A 16- to 20-week course of isotretinoin treatment at the recommended dose for severe acne has no clinically significant effect on lumbar spine and total hip BMD in the adolescent (12-17 years) population.
authors.affiliation: Division of Dermatopharmacology, Department of Dermatology, Brown Medical School/Rhode Island Hospital, Providence, RI 02903, USA. John_DiGiovanna_MD@Brown.edu
authors.forename: John J
authors.initials: JJ
authors.lastname: DiGiovanna
authors.forename: Craig B
authors.initials: CB
authors.lastname: Langman
authors.forename: Eduardo H
authors.initials: EH
authors.lastname: Tschen
authors.forename: Terry
authors.initials: T
authors.lastname: Jones
authors.forename: Alan
authors.initials: A
authors.lastname: Menter
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Lowe
authors.forename: Lawrence
authors.initials: L
authors.lastname: Eichenfield
authors.forename: Adelaide A
authors.initials: AA
authors.lastname: Hebert
authors.forename: David
authors.initials: D
authors.lastname: Pariser
authors.forename: Ronald P
authors.initials: RP
authors.lastname: Savin
authors.forename: Stacy R
authors.initials: SR
authors.lastname: Smith
authors.forename: Michael
authors.initials: M
authors.lastname: Jarratt
authors.forename: David
authors.initials: D
authors.lastname: Rodriguez
authors.forename: Dan K
authors.initials: DK
authors.lastname: Chalker
authors.forename: Steven
authors.initials: S
authors.lastname: Kempers
authors.forename: Mark
authors.initials: M
authors.lastname: Ling
authors.forename: Elyse S
authors.initials: ES
authors.lastname: Rafal
authors.forename: Sabra
authors.initials: S
authors.lastname: Sullivan
authors.forename: Sewon
authors.initials: S
authors.lastname: Kang
authors.forename: Leena P
authors.initials: LP
authors.lastname: Shah
authors.forename: Emily
authors.initials: E
authors.lastname: Wu
authors.forename: Julie
authors.initials: J
authors.lastname: Newhouse
authors.forename: Jonathan
authors.initials: J
authors.lastname: Pak
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Eberhardt
authors.forename: Graeme F
authors.initials: GF
authors.lastname: Bryce
authors.forename: John A
authors.initials: JA
authors.lastname: McLane
authors.forename: Michael
authors.initials: M
authors.lastname: Ondovik
authors.forename: Catherine
authors.initials: C
authors.lastname: Chin
authors.forename: Ko-Chin
authors.initials: KC
authors.lastname: Khoo
authors.forename: Phoebe
authors.initials: P
authors.lastname: Rich
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D000293:Adolescent; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004334:Drug Administration Schedule; D005260:Female; D006615:Hip / Q000502:physiology; D006801:Humans; D015576:Hyperostosis / Q000139:chemically induced; D015474:Isotretinoin / Q000008:administration & dosage / Q000009:adverse effects*; D008159:Lumbar Vertebrae / Q000502:physiology; D008297:Male; D011446:Prospective Studies
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin