Dermatology Department, Faculté de Médecine, Université Saint-Joseph, Beirut, Lebanon.
Dermatology Department, Hôtel-Dieu de France University Hospital, Boulevard Alfred Naccache, Beirut, 16-6830, Lebanon.
Arch Dermatol Res. 2023 Aug;315(6):1533-1539. doi: 10.1007/s00403-023-02532-6. Epub 2023 Jan 19.
Oral isotretinoin remains the most effective treatment for acne. The aim of this retrospective single-center cohort study was to estimate the prevalence of adverse events with the different oral isotretinoin brands used in acne treatment. The population consisted of all patients who consulted for acne between January 2015 and January 2020. The inclusion criterion was the initiation of treatment with oral isotretinoin. The exclusion criteria were the use of two or more brands during the same course of treatment and previous treatment with oral isotretinoin. Statistical analysis was carried out using Chi-square and Mann-Whitney tests. We analyzed 468 patients of whom 68.6% were female. The median age was 21 years. The median weight was 65 kg. The treatment was Roaccutane, Curacné, Acnotren, Isosupra, Contracné, or Acnogen in 44.2%, 28%, 14.5%, 10.5%, 1.7% and 0.4% of cases, respectively. Xerosis was the most frequently reported side effect regardless of the brand. The highest frequencies of hypercholesterolemia (25.6%) and eczema (13%) were noted with Roaccutane; hypertriglyceridemia (16.8%), epistaxis (9.9%) and fatigue (3.1%) with Curacné; excessive sweating (4.1%) and headache (4.1%) with Isosupra; and abnormal liver function tests (11%) with Acnotren. We found a significant correlation mainly between abnormal ASAT and Acnotren (p = 0.009), hypercholesterolemia and Roaccutane [OR = 1.652 (95% CI 1.056-2.585)], hypertriglyceridemia and higher body weight (p = 0.004). Factors related to the drug brand and to characteristics of acne patients could explain the variability in the prevalence of some adverse events.
口服异维 A 酸仍然是治疗痤疮最有效的方法。本回顾性单中心队列研究旨在评估不同品牌口服异维 A 酸治疗痤疮的不良反应发生率。该人群包括 2015 年 1 月至 2020 年 1 月期间因痤疮就诊的所有患者。纳入标准为开始口服异维 A 酸治疗。排除标准为同一疗程使用两种或两种以上品牌以及既往口服异维 A 酸治疗。使用卡方检验和曼-惠特尼检验进行统计分析。我们分析了 468 名患者，其中 68.6%为女性。中位年龄为 21 岁。中位体重为 65 公斤。治疗药物分别为 Roaccutane、Curacné、Acnotren、Isosupra、Contracné 和 Acnogen，占比分别为 44.2%、28%、14.5%、10.5%、1.7%和 0.4%。无论品牌如何，干燥症都是最常报告的副作用。Roaccutane 组高胆固醇血症（25.6%）和湿疹（13%）的发生率最高；Curacné 组高甘油三酯血症（16.8%）、鼻出血（9.9%）和疲劳（3.1%）发生率最高；Isosupra 组多汗（4.1%）和头痛（4.1%）发生率最高；Acnotren 组肝功能异常（11%）发生率最高。我们发现主要有显著相关性异常 AST 与 Acnotren（p=0.009），高胆固醇血症与 Roaccutane [OR=1.652（95%CI 1.056-2.585）]，高甘油三酯血症与体重较高（p=0.004）。药物品牌和痤疮患者特征相关的因素可以解释一些不良反应发生率的差异。
