al-Khawajah M M
Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Int J Dermatol. 1996 Mar;35(3):212-5. doi: 10.1111/j.1365-4362.1996.tb01645.x.
The clinical efficacy of oral isotretinoin in the treatment of severe acne is now well established and so are the clinical and laboratory adverse effects of the drug. Isotretinoin was first introduced in Saudi Arabia late in 1987. In this 7-year retrospective study, efficacy and side effects of isotretiunoin are reviewed in Saudi patients with acne vulgaris seen in a university skin clinic in Riyadh, Saudi Arabia.
A total of 262 patients had been treated with isotretinoin. Their case records were studied with reference to demographic data, clinical findings, dosage of isotretinoin, response to the drug, and the prevalence and severity of clinical and laboratory adverse effects.
Only 156 case records (69.9% women) could be evaluated. Most patients received 0.60 to 0.75 mg of isotretinoin per kg per day for a period ranging from 16 to 35 weeks (mean +/- SD: 21.2 +/- 3.3 weeks); a total cumulative dose of 75 to 146 mg per kg (mean +/- SD: 104 +/- 10.6 mg per kg). Approximately 56% of the patients had therapy-resistant moderate acne and only 14% had nodulocystic acne. Of the patients, 90.4% had an excellent response and 3.8% were poor responders. Adverse effects occurred in 99% of the patients, but in no case did they lead to discontinuation of the drug. Except for minor differences in prevalence, the clinical side effects were similar to those reported in the literature. Elevation of plasma triglyceride levels was the most significant laboratory adverse effect.
This is the first report on the experience with isotretinoin in the treatment of acne in the Middle East. Moderate doses of isotretinoin are well tolerated and produce excellent results in Saudi patients with acne.
口服异维A酸治疗重度痤疮的临床疗效已得到充分证实，该药物的临床及实验室不良反应也为人所知。异维A酸于1987年末首次引入沙特阿拉伯。在这项为期7年的回顾性研究中，对沙特阿拉伯利雅得一家大学皮肤诊所中患有寻常痤疮的沙特患者使用异维A酸的疗效和副作用进行了评估。
共有262例患者接受了异维A酸治疗。对他们的病例记录进行了研究，内容涉及人口统计学数据、临床检查结果、异维A酸剂量、对药物的反应以及临床和实验室不良反应的发生率及严重程度。
仅156份病例记录（69.9%为女性）可供评估。大多数患者每天每千克体重服用0.60至0.75毫克异维A酸，疗程为16至35周（平均±标准差：21.2±3.3周）；每千克体重的总累积剂量为75至146毫克（平均±标准差：104±10.6毫克/千克）。约56%的患者患有治疗抵抗性中度痤疮，只有14%患有结节囊肿性痤疮。其中，90.4%的患者反应良好，3.8%的患者反应不佳。99%的患者出现了不良反应，但无一例导致停药。除了发生率略有差异外，临床副作用与文献报道的相似。血浆甘油三酯水平升高是最显著的实验室不良反应。
这是中东地区关于异维A酸治疗痤疮经验的首份报告。中等剂量的异维A酸耐受性良好，在沙特痤疮患者中产生了优异的治疗效果。
