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Pharmacology and Treatment

Roaccutane Treatment Guidelines: Results of an International Survey

Cunliffe W.J.a · van de Kerkhof P.C.M.c · Caputo R.d · Cavicchini S.d · Cooper A.e · Fyrand O.L.f · Gollnick H.g · Layton A.M.b · Leyden J.J.h · Mascaró J.-M.j · Ortonne J.-P.k · Shalita A.i

Author affiliations

aLeeds General Infirmary, Leeds, and bHarrogate District Hospital, Harrogate, UK; cUniversity of Nijmegen, The Netherlands; dUniversity of Milano, Italy; eRoyal North Shore Hospital, University of Sydney, Australia; fRikshospitalet, Oslo, Norway; gUniversity of Magdeburg, Germany; hUniversity of Pennsylvania, Philadelphia, Pa., and iState University of New York at Brooklyn, N.Y., USA; jUniversity of Barcelona, Spain; kHôpital Pasteur, Nice, France

Related Articles for ""

Dermatology 1997;194:351–357

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Article / Publication Details

First-Page Preview
Abstract of Pharmacology and Treatment

Received: March 11, 1997
Accepted: April 15, 1997
Published online: October 06, 2009
Issue release date: 1997

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM

Abstract

Background: Oral isotretinoin (Roaccutane®) revolutionized the treatment of acne when it was introduced in 1982. Methods: Twelve dermatologists from several countries with a special interest in acne treatment met to formally review the survey of their last 100 acne patients treated with oral isotretinoin. The primary purpose of the survey was to identify the types of acne patients who were prescribed oral isotretinoin and how the patients were managed. Results: Of the 1,000 patients reviewed, 55% of those who received oral isotretinoin had those indications treated historically, i.e. severe nodular cystic acne or severe inflammatory acne, not responding to conventional treatment. Forty-five percent of patients who were prescribed oral isotretinoin however had either moderate or mild acne. Most patients in this group had moderate acne (85%). However, 7.3% had mild acne on physical examination. The criteria for prescribing oral isotretinoin in this less severe group of patients included acne that improves < 50% after 6 months of conventional oral antibiotic and topical combination therapy, acne that scars, acne that induces psychological distress and acne that significantly relapses during or quickly after conventional therapy. Treatment is usually initiated at daily doses of 0.5 mg/kg (but may be higher) and is increased to 1.0 mg/kg. Most of the physicians aimed to achieve a cumulative dose of > 100–120 mg/kg. Mucocutaneous side-effects occur frequently but are manageable while severe systemic side-effects are rarely problematic (2%). The teratogenicity of oral isotretinoin demands responsible consideration by both female patients and their physicians. Significant cost savings when treating acne patients with oral isotretinoin as compared to other treatment modalities were further proven in this study. Conclusions: Our recommendation is that oral isotretinoin should be prescribed not only to patients with severe disease but also to patients with less severe acne, especially if there is scarring and significant psychological stress associated with their disease. Acne patients should, where appropriate, be prescribed isotretinoin sooner rather than later.

© 1997 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Pharmacology and Treatment

Received: March 11, 1997
Accepted: April 15, 1997
Published online: October 06, 2009
Issue release date: 1997

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 0

ISSN: 1018-8665 (Print)
eISSN: 1421-9832 (Online)

For additional information: http://www.karger.com/DRM


Copyright / Drug Dosage / Disclaimer

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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