Effects of Isotretinoin treatment on human body - review
DOI:
https://doi.org/10.12775/QS.2024.21.53674Keywords
retinoids, isotretinoin, acne, 13-cis-retinoic acidAbstract
Introduction: Isotretinoin (13-cis-Retinoic Acid) is a part of the retinoid group, and is used in dermatology for the treatment of acne, due to its demonstrated inhibitory effect on sebaceous gland activity and proliferation. Isotretinoin is a highly lipophilic drug, for this reason taking it with food, doubles the bioavailability of the substance, during systemic treatment. Isotretinoin as a drug has been used effectively for more than 40 years in the treatment of acne, although its exact mechanism of action is not known.
Objective: The objective of this study is to gather and analyze literature regarding the adverse effects of isotretinoin therapy on mental health and the digestive, cardiovascular, immune, urinary, and reproductive systems.
Materials and Methods: A literature review was conducted using the PubMed database with the following search terms : retinoids, isotretinoin, acne, 13-cis-retinoic acid.
Current Knowledge: Isotretinoin therapy has a vast spectrum of side effects affecting various systems of the human body. During the use of isotretinoin, special caution should be taken in patients with depression, lipid disorders, and abnormal liver function. In addition, in patients of childbearing age, make sure to use contraception one month before, during and one month after the end of isotretinoin therapy due to its teratogenicity.
Conclusion: Isotretinoin is still the most effective drug in the systemic treatment of severe forms of acne, nevertheless its potential side effects should be kept in mind. Regular monitoring of patients should be a mainstay during isotretinoin therapy, especially with regard to lipid profile and liver parameters.
References
Bremner JD, Shearer KD, McCaffery PJ. Retinoic acid and affective disorders: the evidence for an association. The Journal of Clinical Psychiatry. 2012 Jan 1;73(1):37–50.
Vallerand IA, Lewinson RT, Farris MS, Sibley CD, Ramien ML, Bulloch AGM, et al. Efficacy and adverse events of oral isotretinoin for acne: a systematic review. British Journal of Dermatology. 2017 Dec 8;178(1):76–85.
Brecher AR, Orlow SJ. Oral retinoid therapy for dermatologic conditions in children and adolescents. Journal of The American Academy of Dermatology. 2003 Aug 1;49(2):171–82.
Brzezinski P, Borowska K, Chiriac A, Smigielski J. Adverse effects of isotretinoin: A large, retrospective review. Dermatologic Therapy. 2017 Mar 14;30(4):e12483.
Miqdad MA, Alatta L, Abdelsamad A, Fouda S, Cherukuri ASS, Eltanany M, et al. Isotretinoin-Induced Inflammatory Bowel Disease: Is There a Real Association? Cureus. 2022 Oct 2;
Papaconstantinou I. Isotretinoin and ulcerative colitis: A case report and review of the literature. World Journal of Gastrointestinal Surgery. 2014;6(7):142.
Banderowicz P, Agnieszka Roszyk, Wierzbowska N, Rodak M. The effect of isotretinoin therapy on the circulatory system. Forum Dermatologicum. 2024 Feb 16;10(1).
Lorenzo N, Antuña P, Dominguez L, Rivero F, Bastante T, Alfonso F. Acute myocardial infarction in a young woman on isotretinoin treatment. International journal of cardiology. 2015 Feb 1;181:39–41.
Anick Bérard, Azoulay L, Hamid Reza Nakhai-Pour, Krystel Moussally. Isotretinoin and the Risk of Cardiovascular, Cerebrovascular and Thromboembolic Disorders. Dermatology. 2011 Jan 1;223(1):45–51.
Cox RA, García-Palmieri MR. Cholesterol, Triglycerides, and Associated Lipoproteins [Internet]. Nih.gov. Butterworths; 2000. Available from: https://www.ncbi.nlm.nih.gov/books/NBK351/
CAN HASDEMIR, ABDI SAGCAN, CEVAT SEKURI, MUGE ILDIZLI, CEM ULUCAN, CEYLAN C. Isotretinoin (13-cis-retinoic acid) Associated Atrial Tachycardia. Pacing and clinical electrophysiology. 2005 Apr 1;28(4):348–9.
Soriano EA, Azevedo PS, Miot HA, Minicucci MF, Pansani MC, Matsubara LS, et al. Cardiac remodeling induced by 13-cis retinoic acid treatment in acne patients. International Journal of Cardiology. 2013 Feb 1;163(1):68–71.
Pepe M, Napoli G, Maria Cristina Carella, Daniele De Feo, Tritto R, Andrea Igoren Guaricci, et al. A Young Patient Presenting with Dilated Cardiomyopathy and Renal Infarction during Treatment with Isotretinoin: Mere Coincidence or Serious Side Effect of a Drug Commonly Used in Adolescence? Diagnostics. 2023 Apr 25;13(9):1543–3.
Laroche ML, Macian-Montoro F, Merle L, Jean-Michel Vallat. Cerebral Ischemia Probably Related to Isotretinoin. Annals of pharmacotherapy/The annals of pharmacotherapy. 2007 Jun 1;41(6):1073–6.
Karapınar T, Polat M, Buğdaycı G. Evaluation of subclinical atherosclerosis in Turkish patients with acne vulgaris receiving systemic isotretinoin. Dermatologic Therapy. 2020 Mar 25;33(3).
McKERROW KJ, MACKIE RM, LESKO MJ, PEARSON C. The effect of oral retinoid therapy on the normal human immune system. British Journal of Dermatology. 1988 Sep;119(3):313–20.
Karadag AS, Ertugrul DT, Bilgili SG, Takci Z, Akin KO, Calka O. Immunoregulatory effects of isotretinoin in patients with acne. British Journal of Dermatology. 2012 Jun 25;167(2):433–5.
Kapała J, Lewandowska J, Placek W, Owczarczyk-Saczonek A. Adverse Events in Isotretinoin Therapy: A Single-Arm Meta-Analysis. International Journal of Environmental Research and Public Health. 2022 May 26;19(11):6463.
Demirci Saadet E, Sahin U. Evaluation of hematological parameters in patients using systemic isotretinoin with diagnosis of acne vulgaris. Journal of Cosmetic Dermatology. 2023 Mar 1;22(3):1077–82.
Armaly Z, Haj S, Bowirrat A, Alhaj M, Jabbour A, Fahoum Y, et al. Acute kidney injury following isotretinoin treatment. The American Journal of Case Reports. 2013;14:554–6.
Oers van, Jaap de Leeuw, Bommel van. Nephrotic syndrome associated with isotretinoin. Nephrology Dialysis Transplantation. 2000 Jun 1;15(6):923–4.
Roenigk HH. Liver toxicity of retinoid therapy. Journal of the American Academy of Dermatology. 1988 Jul 1;19(1):199–208.
Kızılyel O, Metin MS, Elmas ÖF, Çayır Y, Aktaş A. Effects of oral isotretinoin on lipids and liver enzymes in acne patients. Cutis. 2014 Nov 1;94(5):234–8.
Jamshidi M, Obermeyer RJ, Govindaraj S, Garcia A, Ghani A. Acute pancreatitis secondary to isotretinoin-induced hyperlipidemia. The Journal of the Oklahoma State Medical Association. 2002 Feb 1;95(2):79–80.
Niharika Dhattarwal, Niti Khunger, Lal A. Isotretinoin Induced Pancreatitis: A Rare Idiosyncratic Reaction. PubMed. 2023 Apr 1;67(6):781–3.
Dogan E. Does isotretinoin have an effect on glucose metabolism, insulin growth factor-1 and insulin-like growth factor-3 binding protein? Przegląd Dermatologiczny. 2021 Jan 1;108(5):361–71.
Paschalidou E, Georgios Katsaras, Papoulakis T, Evangelia Kalloniati, Dimitrios Kavvadas, Karachrysafi S, et al. The Effect of Isotretinoin on Insulin Resistance and Serum Adiponectin Levels in Acne Vulgaris Patients: A Systematic Review and Meta-Analysis. Clinics and Practice. 2024 May 31;14(3):1021–37.
Çinar L, Kartal D, Ergin C, Aksoy H, Karadag MA, Aydin T, et al. The effect of systemic isotretinoin on male fertility. Cutaneous and Ocular Toxicology. 2015 Dec 11;35(4):296–9.
Draghici CC, Miulescu RG, Petca RC, Petca A, Dumitrașcu MC, Șandru F. Teratogenic effect of isotretinoin in both fertile females and males (Review). Experimental and Therapeutic Medicine. 2021 May 1;21(5):534.
Alhetheli G, Alhazmi S, Almutairi S, Alharbi S, Alharbi N, Alsweed M, et al. The Effects of Isotretinoin on The Menstrual Cycle: A Cross-Sectional Study. Clinics & Practice. 2022 Dec 1;12(6):908–17.
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Copyright (c) 2024 Adam Słomczyński, Piotr Zatyka, Agata Pawłowska, Michal Rabenda, Piotr Janik, Dobromiła Osuch, Dominika Opala
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