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Accutane, the most powerful medication available to treat severe acne, causes increased cholesterol and fat deposits in the blood in more people than previously thought, but the vast majority of those cases are mild and disappear once patients stop taking the drug, according to a new study of nearly 14, Northern California Kaiser Permanente members. Doctors have long known that isotretinoin, which is best known under the brand name Accutane, frequently causes triglyceride -- a fat in the blood -- and cholesterol levels to climb, triggering concerns that taking the drug could lead to heart problems.
But the results of the study, a co-author says, should be comforting to doctors who prescribe isotretinoin. That's good news," said Dr. Michele Manos of Kaiser. For years, doctors have been instructed to perform regular blood tests to check for half a dozen abnormalities possibly caused by isotretinoin.
The new findings indicate that three of those tests may not be necessary because the drug does not cause abnormal results for certain blood cells. And while the drug does elevate levels of triglyceride and cholesterol, the increases are almost always minor.
Lab tests that show the presence of high levels of cholesterol and triglyceride "does not guarantee a heart attack," said Dr. He added that further studies are needed to evaluate the long-term effects of using isotretinoin and whether patients report higher incidences of heart problems.
The study -- the largest ever performed on the drug -- looked at 13, Kaiser patients who were treated with isotretinoin between March and September Of those patients, 44 percent showed an increase in levels of triglyceride.
The packaging for isotretinoin states that 25 percent of patients in clinical trials showed an increase in triglyceride. The study showed 31 percent of patients with increased cholesterol levels. Previous studies have reported increased cholesterol levels in 6 to 32 percent of patients. The Kaiser study also showed 11 percent of patients with abnormal liver function tests, which was a lower rate than previous studies have reported.
The increases were mild in more than 90 percent of cases for triglyceride and cholesterol results, as well as the liver function tests. And in almost all patients, the abnormal results disappeared shortly after treatment ended. That sort of flies in the face of our prior notions that this drug has bad effects on triglycerides," Zane said. Isotretinoin still is considered a potentially dangerous drug. The drug can cause fetal heart and brain defects, and as an extra measure to protect against such birth defects, the Food and Drug Administration two years ago strengthened restrictions on isotretinoin by creating a national registry of those taking it.
Men and women who are prescribed isotretinoin must be added to the registry, along with physicians who prescribe the drug and pharmacies that sell it. Patients typically take isotretinoin daily for four to eight months. While on the drug, they must visit their doctor at least once a month for testing and educationand to confirm that female users have not become pregnant.
Isotretinoin also has been associated with severe depression and suicidal thoughts, according to the FDA. Still, Zane said the drug has been a highly effective tool for patients who have tried many other treatments to get rid of severe acne and are out of options.
It's like a new life for them.
Background: Many studies have demonstrated an increase in total cholesterol and triglycerides on oral isotretinoin therapy. The study found that 31% of patients taking Accutane ended up with high cholesterol levels, 44% developed high triglycerides while 11% had. Background: Isotretinoin (iso) is associated with elevated lipid levels including elevated triglycerides (trigs), LDL, HDL, and total cholesterol. The study found that 31% of patients taking Accutane ended up with high cholesterol levels, 44% developed high triglycerides while 11% had. Great questions! We sometimes see elevations in triglycerides in patients on Accutane, and sometimes there are elevated total cholesterol levels. Some studies suggest that routine laboratory tests are needed when treating patients with isotretinoin due to severe alterations in serum liver transaminase and lipid levels, while other studies conclude that the effects are minimal and laboratory tests are not needed. To survey US dermatologists regarding laboratory monitoring practices while prescribing isotretinoin. The investigators found increased liver transaminase and serum lipid levels. We have sent a message to the email address you have provided. Men and women who are prescribed isotretinoin must be added to the registry, along with physicians who prescribe the drug and pharmacies that sell it.The authors of this survey-based study evaluated isotretinoin lab monitoring practices among dermatologists. The most commonly observed adverse event was a severely elevated level of triglycerides. Overall, three-quarters of dermatologists monitor LFTs and lipid levels in patients treated with isotretinoin, although, outside of mandated pregnancy testing, no clear agreement exists for laboratory monitoring in these patients.
Isotretinoin is an effective treatment for nodulocystic acne. Outside of required pregnancy testing, laboratory monitoring suggested by the manufacturers is vague. Dermatologists, therefore, monitor a variety of tests with variable frequency. Despite intense monitoring, the majority of patients do not have gross laboratory abnormalities that warrant changes in management. To survey US dermatologists regarding laboratory monitoring practices while prescribing isotretinoin.
There is no consensus on isotretinoin monitoring tests and frequency, though the majority of dermatologists surveyed monitor a lipid panel and LFTs. Property Value Status. We have detected that you are using an Ad Blocker. PracticeUpdate is free to end users but we rely on advertising to fund our site. Please consider supporting PracticeUpdate by whitelisting us in your ad blocker. We have sent a message to the email address you have provided,.
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