Re-evaluating the necessity of routine laboratory monitoring during isotretinoin therapy for acne.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL World Journal of Clinical Cases Pub Date : 2024-10-06 DOI:10.12998/wjcc.v12.i28.6237
Yun-Xia Zhu, Liang Wu, Sheng-Cai Zhu, Xiu-Ping Wang, Deng Zhang, Yan-Ping Tan, Xiao-Liang Ouyang, Chun-Ming Li
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Abstract

In this letter, we discuss the topic of necessity of routine laboratory monitoring during isotretinoin treatment for acne. According to Park and colleagues, it is advisable to monitor the levels of triglycerides, alanine aminotransferase, and aspartate aminotransferase every 5 to 6 months. Additionally, the levels of total cholesterol and low-density lipoprotein should be checked within the first two months of treatment. Isotretinoin is a commonly prescribed agent mainly used to treat acne. Despite its high effectiveness, it necessitates regular monitoring of laboratory parameters due to its side effect profile. Currently, there remains a lack of consensus on the appropriate frequency for monitoring these parameters during treatment with isotretinoin. This letter will provide insight into this complex and controversial topic. Based on existing literature, we concluded that the incidence of changes in lipid and liver aminotransferase levels during isotretinoin treatment for acne was low and likely clinically insignificant. For generally healthy people, we recommend testing lipid and liver profiles once at baseline and a second time at the peak dosage. However, frequent testing might still be beneficial in certain populations of patients.

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重新评估异维A酸治疗痤疮期间常规实验室监测的必要性。
在这封信中,我们讨论了在异维A酸治疗痤疮期间进行常规实验室监测的必要性这一话题。Park 及其同事认为,最好每 5 到 6 个月监测一次甘油三酯、丙氨酸氨基转移酶和天冬氨酸氨基转移酶的水平。此外,还应在治疗的头两个月内检查总胆固醇和低密度脂蛋白的水平。异维A酸是一种常用的处方药,主要用于治疗痤疮。尽管它的疗效很好,但由于其副作用,有必要对实验室指标进行定期监测。目前,对于异维A酸治疗期间监测这些参数的适当频率仍缺乏共识。本信将就这一复杂而有争议的话题发表见解。根据现有文献,我们得出结论:在异维A酸治疗痤疮期间,血脂和肝脏转氨酶水平变化的发生率很低,而且在临床上可能并不显著。对于一般健康人群,我们建议在基线剂量时检测一次血脂和肝功能,在用药高峰时再检测一次。不过,频繁检测对某些患者可能仍然有益。
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World Journal of Clinical Cases
World Journal of Clinical Cases Medicine-General Medicine
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期刊介绍: The World Journal of Clinical Cases (WJCC) is a high-quality, peer reviewed, open-access journal. The primary task of WJCC is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of clinical cases. In order to promote productive academic communication, the peer review process for the WJCC is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJCC are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in clinical cases.
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