The effect of isotretinoin on triglycerides and liver aminotransferases

Abstract

BACKGROUND:Isotretinoin has been used to treat the most severe cases of acne; however, it may provoke adverse events in mucocutaneous and hepatic tissues, lead to alterations in lipid levels and cause teratogenicity. OBJECTIVE: The objective of this study was to evaluate the profile of changes in alanine aminotransferase (ALT), aspartate aminotransferase (AST) and triglyceride levels in patients who had been treated with oral isotretinoin dispensed by the São Mateus/ES pharmacy for special drugs. METHODS: A retrospective, observational, longitudinal study was conducted by carrying out a secondary analysis of each patient's data. RESULTS: Of the 130 patients who received isotretinoin between January and December 2009, only 70 were actually treated for 3 months or more and handed in the results of their laboratory tests. Of these 70 patients, 39 (55.7%) were female. The mean age of the women (23.9 years) was higher than the mean age of the men (20.1 years). There was a statistically significant increase in the levels of triglycerides (87.01 ± 48.25 versus 105.32 ± 48.76 mg/dL), AST (20.44 ± 6.26 versus 24.38 ± 11.92 U/L) and ALT (18.24 ± 8.31 versus 23.34 ± 20.03 U/L) performed prior to and 3 months or more after oral isotretinoin treatment. After treatment with oral isotretinoin, triglyceride levels had increased beyond the normal range in 11% of the patients, while 8.6% had elevated AST levels and 7.3% had increased ALT levels. CONCLUSION:The results in this population show that the use of oral isotretinoin for the treatment of acne may result in altered triglyceride, AST and ALT levels. These findings are in accordance with data published previously in the scientific literature, confirming the need to monitor these patients. Keywords: Acne vulgaris; Aminotransferases; Dermatologic agents; Isotretinoin; Triglycerides Resumo: FUNDAMENTOS: A isotretinoína tem sido usada no tratamento dos casos mais graves de acne, embora possa induzir reações adversas nos tecidos mucocutâneos e hepáticos, alterações nos níveis lipídicos e teratogenicidade. OBJETIVOS: Este estudo avaliou o perfil de alterações nas concentrações de Alanina Aminotransferrase, Aspartato Aminotransferrase e triglicerídeos em pacientes que fizeram uso de isotretinoína oral fornecida pelo serviço Farmácia de Medicamentos Excepcionais de São Mateus/ES. MÉTODOS: Foi realizado estudo observacional longitudinal exploratório retrospectivo, utilizando coleta de dados secundários de cada paciente. Resultados: Dos 130 pacientes que receberam isotretinoína no período de janeiro a dezembro de 2009, somente 70 realizaram o tratamento por 3 meses ou mais e apresentaram os resultados dos exames. Desses 70 pacientes, 39 (55,7%) eram do sexo feminino. A média de idade das mulheres (23,9 anos) foi maior do que a média de idade dos homens (20,1 anos). Houve aumento estatisticamente significante nas dosagens de triglicerídeos (87,01±48,25 versus 105,32 ± 48,76), Aspartato Aminotransferrase (20,44 ± 6,26 versus 24,38 ± 11,92) e Alanina Aminotransferrase (18,24 ...

Analysis of clinical efficacy, side effects, and laboratory changes among patients with acne vulgaris receiving single versus twice daily dose of oral isotretinoin

“…Laboratory tests for serum cholesterol and triglycerides as well as for AST and ALT indicates that all these tests show statistically significant rise in most patients included in the study, with more prominent increase in serum triglycerides (see Table 3). This agrees with previous studies that had shown increased values of serum cholesterol, triglycerides, AST, and ALT during treatment with oral isotretinoin with more prominent increase in serum triglycerides (8,13,15). However, when compared with the CTCAE (Table 1), our patients' laboratory values during treatment were still within normal ranges in most patients.…”

Effects of Isotretinoin on the Platelet Counts and the Mean Platelet Volume in Patients with Acne Vulgaris

“…The most common side effects are mucocutaneous (dryness, keilit, palmoplantar exfoliation, rash, and dermatitis), gastrointestinal (inflammatory bowel disease), and ocular problems (conjunctivitis, dry eye) [4]. Besides these side effects, isotretinoin is known to cause several laboratory disturbances [8]. Severe hematological changes were previously reported as case reports [9–11].…”

Isotretinoin: efficacy and safety (literature review)

“…Од-нако, по мнению некоторых авторов [56,63], оно может быть ассоциировано с повышением риска бо-лезней печени и сердечно-сосудистой системы. Именно поэтому рекомендуется исследовать сыво-роточный уровень ферментов до начала лечения, через 1 мес, а затем каждые 3 мес.…”

“…Факторами риска считают макрокомедоны и круп-ные узлы. В более ранних работах [63] эксперты ре-комендовали для купирования обострения исполь-зовать короткие курсы (3-6 нед) приема преднизо-лона в суточной дозе 0,5-1,0 мг/кг. В настоящее время основной рекомендацией является повыше-ние суточной дозы изотретиноина до 1,0 мг/кг.…”