Ibrahim Shimaa, Osman Bashier, Awaad Reela M, Abdoon Iman
Clinical Pharmacy Program, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan.
Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan.
J Multidiscip Healthc. 2023 Mar 30;16:839-849. doi: 10.2147/JMDH.S405509. eCollection 2023.
Acne vulgaris is a skin disorder primarily affecting teenagers and young adults. Acne relapse is the main drawback of oral isotretinoin (OI), which is the golden therapy for severe acne. This study aimed to assess the rate and predictive factors of acne relapse among Sudanese patients using OI.
A cross-sectional study was conducted in a dermatology and venereology clinic-Sudan, using a self-administered questionnaire and data collection sheet. Patients using OI for acne treatment were enrolled in the study. Chi-square test and logistic regression analysis were used to evaluate the association between variables. P-value <0.05 was considered statistically significant.
225 acne patients (mean age: 26.0±4.2 years, females: 88.9%) were included in this study. OI daily dose ranged from 0.25 to 1 mg/kg/day, with frequent daily doses of 40-49 mg (57.3%) over 3-6 months (81.8%). Around one-third of patients (36%) received maintenance therapy after completion of OI course. At a 2-year follow-up, approximately 36% of patients experienced acne relapse that commonly occurred within 6-18 months after the last OI therapy. Early discontinuation of OI was a positive predictor of acne relapse which was 3.99 times greater in patients who had early discontinued OI than those completing the planned OI course (OR=3.99; =0.002). OI cumulative doses of 120-139 mg/kg and 140-159 mg/kg were negative predictors of acne relapse (OR=0.23; =0.001 and OR=0.15; =0.02, respectively). Most patients (94.2%) received prescription OI, and 76.4% of women were advised to use contraceptives. About 69% of patients practiced skin care.
About one-third of patients experienced acne relapse. Early discontinuation and low cumulative doses of OI are the main risk factors for acne relapse. Long-term therapy of OI, with cumulative doses of 120-159 mg/kg, would be beneficial to reduce acne relapse.
寻常痤疮是一种主要影响青少年和年轻成年人的皮肤疾病。痤疮复发是口服异维A酸（OI）的主要缺点，而OI是重度痤疮的黄金治疗方法。本研究旨在评估苏丹使用OI的患者中痤疮复发的发生率及预测因素。
在苏丹的一家皮肤科和性病科诊所进行了一项横断面研究，采用自行填写的问卷和数据收集表。纳入使用OI治疗痤疮的患者。采用卡方检验和逻辑回归分析来评估变量之间的关联。P值<0.05被认为具有统计学意义。
本研究纳入了225例痤疮患者（平均年龄：26.0±4.2岁，女性：88.9%）。OI的每日剂量范围为0.25至1mg/kg/天，在3至6个月内（81.8%）每日常用剂量为40 - 49mg（57.3%）。约三分之一的患者（36%）在完成OI疗程后接受了维持治疗。在2年的随访中，约36%的患者出现痤疮复发，复发通常发生在最后一次OI治疗后的6至18个月内。过早停用OI是痤疮复发的一个阳性预测因素，过早停用OI的患者痤疮复发的可能性是完成计划OI疗程患者的3.99倍（OR = 3.99；P = 0.002）。OI累积剂量为120 - 139mg/kg和140 - 159mg/kg是痤疮复发的阴性预测因素（分别为OR = 0.23；P = 0.001和OR = 0.15；P = 0.02）。大多数患者（94.2%）接受的是处方OI，76.4%的女性被建议使用避孕药。约69%的患者进行皮肤护理。
约三分之一的患者出现痤疮复发。过早停用OI和OI累积剂量低是痤疮复发的主要危险因素。OI累积剂量为120 - 159mg/kg的长期治疗将有助于减少痤疮复发。
