The American Academy of Dermatology Association has updated its position statement on the use of isotretinoin, continuing to support physician-monitored use of the drug for severe acne.
"Isotretinoin continues to be considered a critically important drug for treating patients with severe acne who fail other therapies," Dr. William D. James, president of the AAD, noted in a statement. "Isotretinoin offers our patients with severe acne significant, life-changing benefits. Providing this medicine safely is our top priority."
The update follows the publication of studies that failed to support claims of a link between depression and isotretinoin and a link between inflammatory bowel disease and isotretinoin.
In particular, the group noted that "a correlation between isotretinoin use and depression/anxiety symptoms has been suggested but an evidence-based causal relationship has not been established."
A study published in November suggested that suicide risk is more likely related to the psychological effects associated with severe acne than to isotretinoin use (BMJ 2010;341:c5812).
Likewise, the group stated that "current evidence is insufficient to prove either an association or a causal relationship between isotretinoin use and inflammatory bowel disease (IBD) in the general population."
In two studies published in 2009, researchers found no clear relationship between isotretinoin and IBD (Am. J. Gastroenterol. 2009;104:2774-8 and Am. J. Gastroenterol. 2009;104:2387-93).
Physicians should be aware of these potential concerns and discuss them with their patients. Physicians should also monitor patients for any indication of these symptoms, noted Dr. James.
The AAD also called for continued compliance with the manufacturer-sponsored and FDA-approved risk management program for prescribing isotretinoin (iPLEDGE).
The complete position statement on isotretinoin is available on the AAD’s Web site.