title: Isotretinoin use and the risk of inflammatory bowel disease: a population-based cohort study.
abstract: Limited evidence suggests that isotretinoin may be associated with inflammatory bowel disease (IBD). To explore this association, we conducted a retrospective population-based cohort study in British Columbia, Canada, among participants who were newly treated with isotretinoin or topical acne medications. The entire population of untreated provincial residents aged 12-29 years served as the reference group. During the 12-year study period, we identified 46,922 participants treated with isotretinoin, 184,824 treated with a topical acne medication, and 1,526,946 untreated individuals. Compared with untreated individuals, we observed no significant association between isotretinoin use and IBD (rate ratio (RR) 1.14; 95% confidence interval (CI) 0.92-1.41). As expected, we found no association with topical acne medications (RR 1.11; 95% CI 0.99-1.24). In prespecified secondary analyses, isotretinoin was associated with IBD among individuals aged 12-19 years (RR 1.39; 95% CI 1.03-1.87) and topical acne medications were associated with ulcerative colitis (RR 1.19; 95% CI 1.00-1.42). Our primary analyses found no association between isotretinoin and IBD. In prespecified secondary analyses, some evidence was found of associations with isotretinoin as well as topical acne medications, suggesting a possible association between IBD and acne itself. Additional research is needed to explore this possibility.
authors.affiliation: Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Raed O
authors.initials: RO
authors.lastname: Alhusayen
authors.forename: David N
authors.initials: DN
authors.lastname: Juurlink
authors.forename: Muhammad M
authors.initials: MM
authors.lastname: Mamdani
authors.forename: Richard L
authors.initials: RL
authors.lastname: Morrow
authors.forename: Neil H
authors.initials: NH
authors.lastname: Shear
authors.forename: Colin R
authors.initials: CR
authors.lastname: Dormuth
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy* / Q000453:epidemiology*; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D015474:Isotretinoin / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin