Isotretinoin Doubts
Is there a relationship between the consumption of isotretinoin and the appearance of inflammatory bowel disease?
In recent years, as a result of some isolated cases, hypotheses have appeared that seemed to link the consumption of isotretinoin for the treatment of acne as a risk factor for suffering from or aggravating an inflammatory bowel disease (both ulcerative colitis and Crohn’s disease).
In the most recent reviews of the scientific literature, a number of facts have been observed that explain why it was initially thought that there might be a link between isotretinoin and inflammatory bowel disease. The conclusions are as follows:
- No statistical relationship has been found between isotretinoin consumption and the onset or worsening of inflammatory bowel disease, but there does appear to be an association between the presence of severe acne and inflammatory bowel disease.
- There is a higher prevalence of acne in patients with complex inflammatory syndromes (SAPHO and PAPA) that are associated with a higher frequency of inflammatory bowel disease.
- The average age of onset of inflammatory bowel diseases is around 19 years, as is often the case with severe acne that is usually treated with isotretinoin.
“In summary, it seems that acne itself could be a risk factor for inflammatory bowel disease, and not isotretinoin”
REFERENCES
· Derrick J. Stobaugh, Parakkal Deepak, Eli D. Ehrenpreis Alleged isotretinoin-associated inflammatory bowel disease: Disproportionate reporting by attorneys to the Food and Drug Administration Adverse Event Reporting System. J Am Acad Dermatol 2013; 69(3): 393-398.
· Etminan M, Bird ST, Delaney JA, Bressler B, Brophy JM. Isotretinoin and Risk for Inflammatory Bowel Disease: A Nested Case-Control Study and Meta-analysis of Published and Unpublished Data. JAMA Dermatol. 2013; 149(2):216-220.
· Alhusayen, Raed O, Juurlink, David N, Mamdani, Muhammad M, et al. Isotretinoin Use and the Risk of Inflammatory Bowel Disease: A Population-Based Cohort Study. J Invest Dermatol. 2013 April. 133: 907–912.
· Femia, Alisa N Ann Vleugels, Ruth Toward Improved Understanding of a Potential Association between Isotretinoin and Inflammatory Bowel Disease. J Invest Dermatol 2013 April. 133: 866-868.