Monthly Lab Testing Not Necessary With Common Acne Medicine

Monthly laboratory testing may not be necessary for patients taking the standard doses of oral isotretinoin (13-cis retinoic acid; first marketed as Accutane) for the treatment of acne, according to a review and meta-analysis published online Dec. 2, 2015 in JAMA Dermatology. While the drug is known to adversely affect cholesterol and triglyceride levels, these changes usually occur early in the course of treatment and few effects are severe or high-risk. Thus, the authors say, less frequent laboratory monitoring may be cost saving and reduce patient discomfort and inconvenience. The drug package insert recommends baseline fasting lipid and hepatic panels with repeated testing at weekly or biweekly intervals until “the response has been established,” but there are no specific suggestions for ongoing monitoring. In 2004 the American Academy of Dermatology published a consensus statement recommending periodic monitoring of serum triglyceride and cholesterol levels, as well as transaminase levels. But, dermatologists’ actual testing patterns are not known. The current meta-analysis included 26 clinical trials (1,574 patients) of oral isotretinoin (lasting at least four weeks) in patients aged 9 to 35 years with acne vulgaris. Laboratory values for lipid levels, hepatic function, and complete blood cell count were evaluated. The study’s key […]