Inflammatory bowel disease caused by isotretinoin: Systematic evaluation of 193 cases with meta-analysis

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Abstract

Objective: Isotretinoin (IST) is used in the treatment of severe nodulocystic acne. A causal relationship between IST use and inflammatory bowel disease (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD) is a matter of debate. We systematically evaluated 193 cases of IBD associated with the use of IST. Methods: A PubMed search using the terms isotretinoin, inflammatory bowel disease and Crohn's disease was performed without time or language barrier. Additional papers were manually added from reference lists of key papers. Qualitative metaanalysis (QMA) was performed using the well-established methods of Qualitative Research. Results: The search produced 193 cases of IBD where IST had been used for acne. There were 57.4% men and 42.6% women. The mean age was 22.2 years (range 15-50). The mean daily dose of IST was 45 (range 20-80) mg. The mean duration of IST treatment was 4.46 (range 0.3-12) months. UC was seen in 51.6%, CD in 32.4%; it was indeterminate in 16%. A few cases were re-challenged with IST to confirm causality. Conclusions: The etiologic role of IST in IBD is not fully established. The weight of qualitative evidence suggests that IST may cause UC in some genetically predisposed cases. Large prospective human and animal studies are needed.

Original languageEnglish (US)
Pages (from-to)535-536
Number of pages2
JournalInternational Medical Journal
Volume20
Issue number5
StatePublished - Oct 2013

Keywords

  • Acne
  • Crohn's disease
  • Isotretinoin
  • Meta-analysis
  • Ulcerative colitis

ASJC Scopus subject areas

  • Medicine(all)

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