Higher cumulative dosages—but not daily doses—of isotretinoin are associated with lower rates of acne relapse and a second course of isotretinoin, a new study shows.
The new study from researchers at Mass General Brigham examined how often acne recurs after isotretinoin and what factors might put patients at risk of acne coming back. Using data from MarketScan, this retrospective analysis examined patients who had at least one previous acne diagnosis and were treated with a course of isotretinoin lasting at least four months, and who had at least one year of available follow-up data. Of the 19,907 patients, 35% received a subsequent prescription acne treatment, with 22.5% receiving an oral medication; 8.2% were treated with a second course of isotretinoin.
The researchers also found that female patients were at greater risk of having acne recurrence, though they were less likely to be treated with a second course of isotretinoin. Moreover, greater cumulative isotretinoin dose was associated with reduced acne recurrence, but not beyond 220mg/kg, the study showed.
“These findings support that dosing regimens could be individualized to patient goals and preferences,” says John Barbieri, MD, MBA, of the Department of Dermatology and Director of the Advanced Acne Therapeutics Clinic at Brigham and Women’s Hospital in Boston, MA ,and a founding member of the Mass General Brigham healthcare system, in a news release. “So long as a sufficient cumulative dose is reached, it appears that a both lower and higher daily dose regimens can be effective. Since side effects are very dependent on dose, these results can help clinicians work with patients to pick the best dose for them to balance risks and benefits.”
Results are published in JAMA Dermatology.
