Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2023; 11(11): 2435-2442
Published online Apr 16, 2023. doi: 10.12998/wjcc.v11.i11.2435
Optimal laboratory testing protocol for patients with acne taking oral isotretinoin
Yu Jeong Park, Hui Young Shin, Woo Kyoung Choi, Ai-Young Lee, Seung Ho Lee, Jong Soo Hong
Yu Jeong Park, Hui Young Shin, Woo Kyoung Choi, Ai-Young Lee, Seung Ho Lee, Jong Soo Hong, Department of Dermatology, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, Goyang 10326, South Korea
Author contributions: Park YJ, the first author, analyzed the data and wrote the manuscript; Shin HY and Choi WK participated in the data collection; Lee SH and Lee AY reviewed and edited the manuscript; Hong JS was the corresponding author and designed the study; all authors have read and approved the final manuscript.
Supported by the Dongguk University Research Program (2021).
Institutional review board statement: The Institutional Review Board of Dongguk University Ilsan Hospital approved this study (IRB No. DUIH 2022-05-002).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: All data related to this study are presented in this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jong Soo Hong, MD, PhD, Associate Professor, Department of Dermatology, Dongguk University Ilsan Hospital, College of Medicine, Dongguk University, 27, Dongguk-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, Goyang 10326, South Korea. jsttjstt@hanmail.net
Received: January 5, 2023
Peer-review started: January 5, 2023
First decision: January 30, 2023
Revised: February 7, 2023
Accepted: March 23, 2023
Article in press: March 23, 2023
Published online: April 16, 2023
ARTICLE HIGHLIGHTS
Research background

Isotretinoin is a widely prescribed medication for various dermatological conditions, particularly acne. Regular blood tests are performed to monitor its side effects. However, the optimal tests and their timing remain controversial.

Research motivation

Since 2006, many studies have reported that only a small proportion of patients taking isotretinoin have abnormal laboratory test results. Thus, frequent monitoring of isotretinoin treatment may be unnecessary.

Research objectives

This study aimed to evaluate the most efficient testing regimen for patients with acne taking isotretinoin.

Research methods

This retrospective study analyzed medical records obtained from Dongguk University Ilsan Hospital’s electronic medical records database. Independent variables (e.g., sex, total prescription date and dose, daily average prescription dose, underlying disease type, and monthly interval per blood test) were analyzed using repeated-measures analysis of variance.

Research results

Aspartate aminotransferase, alanine aminotransferase, and triglyceride levels significantly changed between 5 and 6 mo when the total prescription period and dose variables were considered altogether. High-density lipoprotein level also significantly changed between 5 and 6 mo. However, low-density lipoprotein and total cholesterol levels significantly changed between 1 and 2 mo.

Research conclusions

Liver and lipid panel should be performed before beginning isotretinoin administration, 1 and 2 mo after administration, and every 6 mo thereafter if no abnormalities are detected to save on costs.

Research perspectives

This article will contribute to Asian-specific isotretinoin laboratory guidelines and further studies.