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Isotretinoin and the risk of inflammatory bowel disease and irritable bowel syndrome: A large-scale global study.
- Source :
-
Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2023 Apr; Vol. 88 (4), pp. 824-830. Date of Electronic Publication: 2022 Dec 15. - Publication Year :
- 2023
-
Abstract
- Introduction: Risk of inflammatory bowel disease under isotretinoin is a scope of a long-standing controversy. The burden of isotretinoin-related irritable bowel syndrome has not been investigated.<br />Objective: To evaluate the risk of Crohn's disease, ulcerative colitis (UC), and irritable bowel syndrome in patients with acne starting isotretinoin vs oral antibiotics treatment.<br />Methods: A global population-based retrospective cohort study assigned 2 groups of patients with acne initiating isotretinoin (n = 77,005) and oral antibiotics (n = 77,005). Comprehensive propensity-score matching was conducted.<br />Results: The lifetime risk of Crohn's disease (hazard ratio [HR], 1.05; 95% CI, 0.89-1.24; P = .583) and UC (HR, 1.13; 95% CI, 0.95-1.34; P = .162) was comparable between study groups, whereas the lifetime risk of irritable bowel syndrome was lower in isotretinoin-prescribed patients (HR, 0.82; 95% CI, 0.76-0.89; P < .001). In time-stratified analysis, isotretinoin-related risk of UC was significantly increased during the first 6 months following drug initiation (HR, 1.93; 95% CI, 1.29-2.88; P = .001), but decreased afterward to level the risk of the comparator group. The absolute risk difference within the first 6 months was clinically marginal (5.0 additional UC cases/10,000 patients starting isotretinoin; 95% CI, 2.5-7.7).<br />Limitations: Retrospective data collection.<br />Conclusion: Isotretinoin does not confer an elevated risk of Crohn's disease, whilst it might be associated with a slight and transient increase in UC risk.<br />Competing Interests: Conflicts of interest None disclosed.<br /> (Copyright © 2022 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Isotretinoin adverse effects
Retrospective Studies
Anti-Bacterial Agents therapeutic use
Crohn Disease drug therapy
Crohn Disease epidemiology
Irritable Bowel Syndrome chemically induced
Irritable Bowel Syndrome epidemiology
Irritable Bowel Syndrome drug therapy
Inflammatory Bowel Diseases drug therapy
Inflammatory Bowel Diseases epidemiology
Colitis, Ulcerative chemically induced
Colitis, Ulcerative drug therapy
Colitis, Ulcerative epidemiology
Acne Vulgaris drug therapy
Acne Vulgaris epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6787
- Volume :
- 88
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of the American Academy of Dermatology
- Publication Type :
- Academic Journal
- Accession number :
- 36529376
- Full Text :
- https://doi.org/10.1016/j.jaad.2022.12.015