Effect of a single course of isotretinoin therapy on bone mineral density in adolescent patients with severe, recalcitrant, nodular acne

John J. Digiovanna, Craig B. Langman, Eduardo H. Tschen, Terry Jones, Alan Menter, Nicholas J. Lowe, Lawrence Eichenfield, Adelaide A. Hebert, David Pariser, Ronald P. Savin, Stacy R. Smith, Michael Jarratt, David Rodriguez, Dan K. Chalker, Steven Kempers, Mark Ling, Elyse S. Rafal, Sabra Sullivan, Sewon Kang, Leena P. ShahEmily Wu, Julie Newhouse, Jonathan Pak, Douglas R. Eberhardt, Graeme F. Bryce, John A. McLane, Michael Ondovik, Catherine Chin, Ko Chin Khoo, Phoebe Rich

Research output: Contribution to journalArticle

Abstract

Background Adverse changes in bone have been reported for patients undergoing high-dose, long-term (several years) isotretinoin therapy for disorders of cornification. The effect of short-term (4-5 months) therapy at the lower dose recommended for acne on bone development in younger, growing adolescent (12-17 years) patients has not been well studied. Objective The purpose of the study was to evaluate the effect of a standard, single course of isotretinoin (Accutane) therapy on bone mineral density (BMD) of the lumbar spine and hip in adolescents ages 12 to 17 years with severe, recalcitrant, nodular acne. Methods In this open-label, multicenter study, 217 adolescents (81 girls) with severe, recalcitrant, nodular acne were enrolled and treated with isotretinoin twice daily with food at the recommended total dose of approximately 1 mg/kg for 16 to 20 weeks. BMD in the lumbar spine and hip was measured at baseline and at the end of therapy by dual energy radiograph absorptiometry. Results There was no clinically significant mean change in BMD measured at the lumbar spine (+1.4%, range: -4.9% to +12.3%) or total hip (-0.26%, range: -11.3% to +15.0%). Hyperostosis was not observed in any patient. Typical effixcacy expected in the treatment of acne was observed. Conclusions A 16- to 20-week course of isotretinoin treatment at the recommended dose for severe acne has no clinically significant effect on lumbar spine and total hip BMD in the adolescent (12-17 years) population.

Original languageEnglish (US)
Pages (from-to)709-717
Number of pages9
JournalJournal of the American Academy of Dermatology
Volume51
Issue number5
DOIs
StatePublished - Nov 1 2004
Externally publishedYes

ASJC Scopus subject areas

  • Dermatology

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    Digiovanna, J. J., Langman, C. B., Tschen, E. H., Jones, T., Menter, A., Lowe, N. J., Eichenfield, L., Hebert, A. A., Pariser, D., Savin, R. P., Smith, S. R., Jarratt, M., Rodriguez, D., Chalker, D. K., Kempers, S., Ling, M., Rafal, E. S., Sullivan, S., Kang, S., ... Rich, P. (2004). Effect of a single course of isotretinoin therapy on bone mineral density in adolescent patients with severe, recalcitrant, nodular acne. Journal of the American Academy of Dermatology, 51(5), 709-717. https://doi.org/10.1016/j.jaad.2004.04.032