title: Evaluation of Evidence for Acne Remission With Oral Isotretinoin Cumulative Dosing of 120-150 mg/kg.
abstract: BACKGROUND
  Oral isotretinoin (ISO) is the standard of care for severe inflammatory acne and a threshold dose of 120-150 mg/kg is widely regarded as increasing remission potential.
  
  
  OBJECTIVE
  Our objective was to evaluate the evidence underlying ISO dosing of 120-150 mg/kg in acne remission.
  
  
  METHODS
  A systematic literature search was performed using keywords "acne," "isotretinoin," "efficacy," "dosing," "relapse," and "remission."
  
  
  RESULTS
  Definitions for acne clearance, relapse/remission, and treatment endpoint vary widely across studies. Only 2 studies explicitly evaluated the cumulative dose of 120-150 mg/kg for induction of acne remission-both low grade.
  
  
  CONCLUSIONS
  The threshold dose of 120-150 mg/kg for oral ISO is based on past parameters of treatment duration and prior studies used vague or inconsistent definitions of clearance and remission. Optimal cumulative doses of ISO required to induce remission appears to vary with severity.
authors.affiliation: Department of Medicine, University of Western Ontario, London, ON, Canada Windsor Clinical Research Inc, Windsor, ON, Canada jerrytan@bellnet.ca.
authors.forename: Jerry
authors.initials: J
authors.lastname: Tan
authors.affiliation: Department of Medicine, University of Western Ontario, London, ON, Canada.
authors.forename: Sanja
authors.initials: S
authors.lastname: Knezevic
authors.affiliation: Windsor Clinical Research Inc, Windsor, ON, Canada.
authors.forename: Sanwarjit
authors.initials: S
authors.lastname: Boyal
authors.affiliation: Department of Medicine, University of Western Ontario, London, ON, Canada.
authors.forename: Brad
authors.initials: B
authors.lastname: Waterman
authors.affiliation: Windsor Regional Hospital, Windsor, ON, Canada.
authors.forename: Toni
authors.initials: T
authors.lastname: Janik
mesh_terms: D000152:Acne Vulgaris / Q000188:drug therapy*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D015474:Isotretinoin / Q000008:administration & dosage*; D012074:Remission Induction
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin
keywords: acne; clearance; dosing; efficacy; isotretinoin; relapse; remission