异维A酸监测趋势：皮肤科医生的全国性调查。
Isotretinoin Monitoring Trends: A National Survey of Dermatologists.
作者信息
Hobson Julia G, Cunningham Michael J, Lesiak Kendra, Lester Elizabeth B, Tegeder Andrew R, Zeeck Elizabeth, Hugh Jeremy M, Lin Julie H
出版信息
J Drugs Dermatol. 2017 Jun 1;16(6):557-564.
BACKGROUND: 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.
OBJECTIVE: To survey US dermatologists regarding laboratory monitoring practices while prescribing isotretinoin.
METHODS: An online survey sent via e-mail to members of the American Academy of Dermatology.
RESULTS: 12,396 surveys were sent with a response rate of ~19%. At baseline >60% of responders check a CBC, LFTs, and a lipid panel. 74% check a monthly lipid panel and LFTs, while 57% check a monthly CBC. 75% report stopping isotretinoin when AST or ALT values reach 3 times normal; 89% report stopping at 4 times normal. When triglycerides reach 4 times normal, 72% stop the medication.
CONCLUSIONS: There is no consensus on isotretinoin monitoring tests and frequency, though the majority of dermatologists surveyed monitor a lipid panel and LFTs.
J Drugs Dermatol. 2017;16(6):557-564.
.背景
异维A酸是治疗结节囊肿性痤疮的有效药物。除了必要的妊娠检测外，制造商建议的实验室监测并不明确。因此，皮肤科医生会以不同频率监测各种检查项目。尽管进行了严格监测，但大多数患者并没有明显的实验室异常情况需要调整治疗方案。
目的
调查美国皮肤科医生在开具异维A酸处方时的实验室监测做法。
方法
通过电子邮件向美国皮肤科协会会员发送在线调查问卷。
结果
共发送了12396份调查问卷，回复率约为19%。在基线时，超过60%的受访者会检查血常规、肝功能和血脂指标。74%的受访者每月检查血脂指标和肝功能，57%的受访者每月检查血常规。75%的受访者报告当谷草转氨酶（AST）或谷丙转氨酶（ALT）值达到正常上限3倍时停用异维A酸；89%的受访者报告在达到4倍正常上限时停用。当甘油三酯达到正常上限4倍时，72%的受访者会停用药物。
结论
对于异维A酸的监测检查项目和频率尚无共识，不过大多数接受调查的皮肤科医生会监测血脂指标和肝功能。
《皮肤用药杂志》2017年；16(6):557 - 564。
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