INTRODUCTION
Isotretinoin has been used to treat severe acne vulgaris since the early 1980s. Initial studies demonstrated acne improvement with dosing regimens of 0.1, 0.5, or 1.0 mg/kg daily.1,2 A decade later, cumulative doses of 120 to 150 mg/kg were shown to limit recurrence and adverse events while maximizing efficacy.3 Subsequently, doses of 220mg/kg and greater have also been proven safe in patients demonstrating limited initial response to therapy and have resulted in significantly decreased risk of relapse.4 Current standard of care uses the patient’s starting weight to determine the cumulative dose, but does not consider the impact of weight change during treatment. For most maturing adolescents, weight change during the treatment period is expected. This study seeks to identify specific patient groups more likely to experience significant changes in weight necessitating adjustments to a target cumulative dose.
MATERIALS AND METHODS
A retrospective cohort study was conducted on patients with acne who were registered in the iPLEDGE database by Augusta University physicians between January 1, 2015, and December 31, 2020. Inclusion criteria included ages 13 to 21 years with documented pre- and post-therapy weights. Patients were stratified by age, sex, and treatment duration in months. Fifty-seven patients were identified; however, 1 outlier with substantial weight loss was excluded (Table 1). Average weight changes with standard deviations were calculated. One-way analysis of variance (ANOVA), unpaired t-test, and Kruskal-Wallis Test were used to determine the significance of weight change within each stratified group.
