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2018, Number 5

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Rev Med Inst Mex Seguro Soc 2018; 56 (5)

Second joint position paper: Use of isotretinoin in severe acne

Gómez-Flores M, Poletti-Vázquez DE, García-Hidalgo L, Fierro-Arias L, Herz-Ruelas M, Garza-Gómez J, Rosas-Ortiz JF

Language: Spanish
References: 16
Page: 441-446
PDF size: 911.75 Kb.


ABSTRACT

Background: The use of isotretinoin is indicated in the treatment of severe acne; however, its adverse effects are important.
Objective: To update the first Mexican Consensus on the use of isotretinoin in severe acne vulgaris, which took place in 2009.
Methods: It was carried out a literature search between June 2009, and February 2015, in order to evaluate topics to be discussed; materials were sent to the experts to promote the debate among participants. The topics of interest were analyzed during the consensus with the Delphi modified method, using an instrument previously validated. 15 certified dermatologists with experience in handling acne with isotretinoin took part in the study; seven of them were involved in the previous consensus.
Results: Several cases of isolated adverse events were identified. Neither systematic reviews, meta-analyses nor comparative, randomized, controlled clinical trials were published during the observation period.
Conclusions: Isotretinoin is still the best treatment for severe nodulocystic acne. However, it must be taken into consideration its teratogenic effect on pregnant women and its association with inflammatory bowel disease, depression and suicidal ideas. Monitoring with laboratory tests is a tool for identifying possible adverse events.


REFERENCES

  1. Piquero J. Isotretinoína: su uso en el acné del adolescente. Dermatol Pediatr Lat. 2004;2(1):72-8. Disponible en http://sisbib.unmsm.edu.pe/bvrevistas/ dpl/v02n01/pdf/a15.pdf

  2. Saldden MJ, Harman KE. What is the chance of a normal pregnancy in a woman whose fetus has been exposed to isotretinoin? Arch Dermatol. 2007;143(9):1187-8.

  3. Bérard A, Azoulay L, Koren G, Blais L, Perreault S, Oraichi D. Isotretinoin, pregnancies, abortions and birth defects: a population-based perspective. Br J Clin Pharmacol. 2007;63(2):196-205. Disponible en https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC1859978/pdf/ bcp0063-0196.pdf

  4. Gómez-Flores M, García-Hidalgo L, Fierro-Arias L, RuizÁvila J, Herz-Ruelas M, Garza-Gómez J. Declaración de posición conjunta: Uso de isotretinoína en acné común. Rev Med Inst Mex Seguro Soc. 2011;49(3):281-8. Disponible en http://revistamedica.imss.gob.mx/editorial/ index.php/revista_medica/article/view/1625/2227

  5. Nelson AM, Zhao W, Gilliland KL, Zaenglein AL, Liu W, Thiboutot DM. Temporal changes in gene expression in the skin in patients treated with isotretinoin provide inside into its mechanisms of action. Dermatoendocrinol. 2009;1 (3):177-87.

  6. Guerra-Tapia A. Isotretinoína en acné. ¿Dosis diaria única o repartida? Med Cutan Iber Lat Am. 2012;40(4): 101-2.

  7. Centro Nacional de Excelencia Tecnológica en Salud. Diagnóstico y tratamiento del acné. Resumen de evidencias y recomendaciones. Guía de Práctica Clínica. México: Secretaría de Salud; 2009. Disponible en http://www. cenetec.salud.gob.mx/descargas/gpc/CatalogoMaestro/224 _SSA_09_Acne/EyR_SSA_224_09.pdf

  8. Nast A, Dréno B, Bettoli V, Degitz K, Erdmann R, Finlay AY, et al; European Dermatology Forum. European evidence-based (S3) guidelines for the treatment of acne. J Eur Acad Dermatol Venereol. 2012 Feb;26 Suppl 1:1-29.

  9. Grupo Ibero-Latinoamericano de Estudio del Acné (GILEA). Guía de tratamiento del acné: algoritmo 2015. Buenos Aires: CILAD; 2015. Disponible en http://www. cilad.org/archivos/1/GILEA/Alg_Acne_2015.pdf

  10. Laboratorio Pierre Fabre. Trevissage: Isotretinoína. Información para prescribir amplia (IPPA). México: Pierre Fabre; 2014.

  11. Lee YH, Scharnitz TP, Muscat J, Chen A, Gupta-Elera G, Kirby JS. Laboratory Monitoring During Isotretinoin Therapy for Acne: A Systematic Review and Metaanalysis. JAMA Dermatol. 2016;152(1):35-44.

  12. Davis SA, Sandoval LF, Gustafson CJ, Feldman SR, Cordoro KM. Treatment of preadolescent acne in the United States: an analysis of nationally representative data. Pediatr Dermatol. 2013;30(6):689-94.

  13. Coloe J, Du H, Morrell DS. Could higher doses of isotretinoin reduce the frecuency of treatment failure in patients with acne? J Am Acad Dermatol. 2011;65(2):422-3.

  14. Cragan JD, Friedman JM, Holmes LB, Uhl K, Green NS, Riley L. Ensuring the safe and effective use of medications during pregnancy: planning and prevention through preconception care. Matern Child Health J. 2006; 10(5 Suppl):S129-35.

  15. Goodfield MJ, Cox NH, Bowser A, McMillan JC, Millard LG, Simpson NB, et al. Advice on the safe introduction and continued use of isotretinoin in acne in the U.K. 2010. Br J Dermatol. 2010;162(6):1172-9.

  16. Sardana K, Garg VK. Low-dose isotretinoin in acne vulgaris: a critical review. Br J Dermatol. 2011;165(3):698- 700.




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