Doctors should not be discouraged from prescribing isotretinoin to adolescents for inflammatory acne, according to a new study by Canadian and U.S. scientists showing the drug does not increase the risk of inflammatory bowel disease (IBD).
Led by Dr. Mahyar Etminan of the Child & Family Research Institute at BC Children’s Hospital, the Provincial Health Services Authority and the University of British Columbia, the scientists addressed this important drug safety question because of a previous study linking the drug to IBD. In this new report published February 20, 2013 in the medical journal JAMA Dermatology, Dr. Etminan’s team says theirs is the first to statistically adjust for severe acne, which is a strong confounding variable that may have led to the overestimation of risk in the earlier study.
The JAMA Dermatology report covered two studies. In one study, the researchers analyzed the health records of a large population of U.S. women between 24-34 years of age. Of the women, 2159 had IBD and 43,180 did not. Only 10 (0.46 per cent) of the women with IBD and only 191 (0.44 per cent) of the women who did not have IBD had used isotretinoin. In the second study, the researchers comprehensively reviewed and analyzed the results of published and unpublished studies. They did not find that isotretinoin increases the risk of IBD.
"We’ve come to the conclusion that there’s no risk that the drug causes inflammatory bowel disease," says Dr. Etminan. "This drug is used for very severe acne that is very traumatic with psychological effects, and it is very effective. Hopefully with this study, it may put dermatologists at ease with prescribing this drug to children and adolescents, knowing that it doesn’t cause this adverse effect."
This research was unfunded. Dr. Etminan is a scientist with the Therapeutic Evaluation Unit at the Child & Family Research Institute and the Provincial Health Services Authority. He is appointed in the Faculty of Medicine at the University of British Columbia. The study was co-led by Dr. James Brophy of McGill University.
The Child & Family Research Institute conducts discovery, translational and clinical research to benefit the health of children and their families. CFRI is supported by BC Children's Hospital Foundation and works in close partnership with the University of British Columbia,
BC Children’s Hospital, and BC Women’s Hospital & Health Centre (agencies of the Provincial Health Services Authority). For more information, visit www.bcchr.ca.
BC Children's Hospital, an agency of the Provincial Health Services Authority, is British Columbia's (BC's) only pediatric hospital and home to many specialized pediatric services available nowhere else in the province, including B.C.’s trauma centre for children, pediatric intensive care, kidney and bone marrow transplants, open heart surgery, neurosurgery and cancer treatment. Sunny Hill Health Centre for Children is the provincial facility that offers specialized child development and rehabilitation services to children and youth. For more information, please visit www.bcchildrens.ca.
The Provincial Health Services Authority (PHSA) plans, manages and evaluates selected specialty and province-wide health care services across BC, working with the five geographic health authorities to deliver province-wide solutions that improve the health of British Columbians. For more information, visit www.phsa.ca.
The University of British Columbia (UBC) is one of North America’s largest public research and teaching institutions, and one of only two Canadian institutions consistently ranked among the world’s 22 best universities. Surrounded by the beauty of the Canadian West, it is a place that inspires bold, new ways of thinking that have helped make it a national leader in areas as diverse as community service learning, sustainability and research commercialization. UBC offers more than 56,000 students a range of innovative programs and attracts $550 million per year in research funding from government, non-profit organizations and industry through over 8,000 projects and grants. For more information, please visit www.ubc.ca.
[JAMA Dermatology article] [JAMA Dermatology editorial] [News release (PDF)]