Clarifying the Purported Association between Isotretinoin and Inflammatory Bowel Disease.
نویسنده
چکیده
Isotretinoin was approved by the Food and Drug Administration (FDA) in 1982 and revolutionized acne therapy. Soon afterwards, case reports appeared suggesting a link between inflammatory bowel disease and use of isotretinoin. As reviewed in this article, an increasing number of case-control and prospective (cohort) studies have been reported that examined associations between use of isotretinoin and inflammatory bowel disease. Published epidemiologic studies of the use of isotretinoin and risk of Crohn's disease and ulcerative colitis vary according to whether the design was a case-control study or cohort study and by other important design differences. The strengths and limitations of the studies, such as their ability to control for important confounding variables (e.g., the severity of acne and use of antibiotics), also differ widely. Results across epidemiologic studies have been inconsistent and most studies have not found a strong association or a dose-response relationship. Based upon results from laboratory studies, several biological mechanisms have been proposed to account for either a positive (pathogenic) or inverse (protective) association between isotretinoin and inflammatory bowel disease. Although epidemiologic study findings are generally consistent with a correct temporal relationship (i.e., exposure to isotretinoin preceded the onset of inflammatory bowel disease), Crohn's disease and ulcerative colitis often have an insidious onset with some symptoms occurring well before a clinical diagnosis of inflammatory bowel disease is made. Taken overall, results from epidemiologic (case-control and cohort) studies completed to date do not show a consistent association between isotretinoin use and risk of inflammatory bowel disease. There is no clear evidence of a causal link.
منابع مشابه
Isotretinoin-induced inflammatory bowel disease.
Three case reports on inflammatory bowel disease associated with use of isotretinoin are described. All three patients were male adolescents, in good health when starting isotretinoin (for acne treatment for about six months). Several weeks after discontinuation of isotretinoin the patients developed severe symptoms requiring hospitalisation. The diagnosis of ulcerative colitis was made in two ...
متن کاملIsotretinoin exposure and risk of inflammatory bowel disease.
IMPORTANCE Isotretinoin is the standard treatment for refractory severe nodulocystic acne.A true association between prior isotretinoin use and development of inflammatory bowel disease (IBD) is uncertain. Addressing the reality of this association is important in decision making for both the clinician and the patient when isotretinoin treatment is indicated.OBJECTIVE To assess the risk of IBD ...
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OBJECTIVE To examine the association between isotretinoin and the risk for inflammatory bowel disease (IBD) among women of reproductive age. DESIGN Nested case-control study and meta-analysis. SETTING A US health claims database. PARTICIPANTS We formed a cohort of women aged 18 to 46 years who had received at least 1 oral contraceptive prescription from May 1, 2001, through December 31, 2...
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ورودعنوان ژورنال:
- Journal of environment and health sciences
دوره 1 2 شماره
صفحات -
تاریخ انتشار 2015