In a consensus statement posted online June 15 in JAMA Dermatologydata are provided to optimize laboratory monitoring of acne patients treated with isotretinoin.
Eric Xia of Harvard Medical School in Boston and his colleagues have established consensus for laboratory monitoring of isotretinoin among clinical and research acne experts. Four rounds of electronic surveys were administered from 2021 to 2022 using a modified electronic Delphi process. For laboratory tests reaching consensus (≥70% agreement) for inclusion, in subsequent cycles, questions regarding more time-specific monitoring throughout isotretinoin treatment were asked. The 22 experts had an average of 23.7 years of practice and represented a variety of practice settings.
Researchers found consensus on whether or not to test was reached to check for alanine aminotransferase in the month prior to onset (89.5%) and at peak dose (89.5%), but not every month (76.2%) or after the end of treatment (73.7%). , and to check triglycerides in the month before starting and at the maximum dose (89.5 and 78.9%, respectively), but not every month or after the end of treatment (84.2 and 73.7% , respectively). Consensus was also reached not to check complete blood cell counts or basic metabolic panel parameters at any time during isotretinoin treatment (all >70 percent), and not to check gamma- glutamyl transferase, bilirubin, albumin, total protein, low density lipoprotein, high density lipoprotein or C-reactive protein (78.9, 81.0, 72.7, 72.7, 73.7, 73.7 and 77.3%, respectively).
“Reducing unnecessary lab checks may help reduce the pain, fear, and direct and indirect costs experienced by patients treated with isotretinoin for acne,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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Eric Xia et al, Laboratory monitoring of isotretinoin in the treatment of acne, JAMA Dermatology (2022). DOI: 10.1001/jamadermatol.2022.2044
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