Isotretinoin Laboratory Monitoring in Acne Treatment: A Delphi Consensus Study - Archive ouverte HAL Access content directly
Journal Articles JAMA Dermatology Year : 2022

Isotretinoin Laboratory Monitoring in Acne Treatment: A Delphi Consensus Study

(1, 2) , (1, 3) , (1, 4) , (5) , (6) , (7) , (8, 9) , (10) , (11) , (12) , (13) , (14) , (15) , (16) , (17) , (10) , (18) , (19) , (20) , (21) , (22) , (23) , (24, 25) , (24, 25) , (1) , (1)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

Abstract

Importance: Although isotretinoin may rarely be associated with laboratory abnormalities such as hypertriglyceridemia, the optimal approach to laboratory monitoring is uncertain, and there is wide variation in clinical practice. Objective: To establish a consensus for isotretinoin laboratory monitoring among a diverse, international cohort of clinical and research experts in acne. Design, setting, and participants: Using a modified electronic Delphi process, 4 rounds of anonymous electronic surveys were administered from 2021 to 2022. For laboratory tests reaching consensus (≥70% agreement) for inclusion, questions regarding more time-specific monitoring throughout isotretinoin therapy were asked in subsequent rounds. The participants were international board-certified dermatologist acne experts who were selected on a voluntary basis based on involvement in acne-related professional organizations and research. Main outcomes and measures: The primary outcome measured was whether participants could reach consensus on key isotretinoin laboratory monitoring parameters. Results: The 22 participants from 5 continents had a mean (SD) time in practice of 23.7 (11.6) years and represented a variety of practice settings. Throughout the 4-round study, participation rates ranged from 90% to 100%. Consensus was achieved for the following: check alanine aminotransferase within a month prior to initiation (89.5%) and at peak dose (89.5%) but not monthly (76.2%) or after treatment completion (73.7%); check triglycerides within a month prior to initiation (89.5%) and at peak dose (78.9%) but not monthly (84.2%) or after treatment completion (73.7%); do not check complete blood cell count or basic metabolic panel parameters at any point during isotretinoin treatment (all >70%); do not check gamma-glutamyl transferase (78.9%), bilirubin (81.0%), albumin (72.7%), total protein (72.7%), low-density lipoprotein (73.7%), high-density lipoprotein (73.7%), or C-reactive protein (77.3%). Conclusions and relevance: This Delphi study identified a core set of laboratory tests that should be evaluated prior to and during treatment with isotretinoin. These results provide valuable data to guide clinical practice and clinical guideline development to optimize laboratory monitoring in patients treated with isotretinoin.
Not file

Dates and versions

inserm-03697023 , version 1 (16-06-2022)

Identifiers

Cite

Eric Xia, Jane Han, Adam Faletsky, Hilary Baldwin, Katie Beleznay, et al.. Isotretinoin Laboratory Monitoring in Acne Treatment: A Delphi Consensus Study. JAMA Dermatology, 2022, Online ahead of print. ⟨10.1001/jamadermatol.2022.2044⟩. ⟨inserm-03697023⟩
5 View
0 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More