But earlier this year, an American team came up with a slightly different conclusion. Looking at about 15 million people in 12 health care claims databases, the authors concluded that 24 cases and 36 controls had been exposed to isotretinoin. Cases were 4.5 times more likely than controls to develop ulcerative colitis, but there was no link between the drug and Crohn’s disease.
“With our two most vigorous studies showing conflicting data, we are left not knowing what to do,” Dr. Baldwin said.
In the meantime, she said, the best physicians can do is strongly warn patients (and their parents) to be on the lookout for GI symptoms, and to report them immediately. The warning must be repeated at every follow-up visit and the medication discontinued if anything untoward develops.
– Michele G. Sullivan