Isotretinoin treatment improved QOL parameters in individuals with acne

More than three-quarters of patients with acne experienced significant improvements in quality-of-life parameters after 4 months of treatment with isotretinoin, according to a study.

“An international task force recommended routine use of quality-of-life measures for clinic visits associated with acne management, but this has yet to translate into clinical practice,” Aaron M. Secrest, MD, PhD, of the department of dermatology at the University of Utah, and colleagues wrote.

In the longitudinal, retrospective case series study, they aimed to evaluate mean Skindex-16 scores over time in a cohort of 57 consecutive patients with moderate to severe acne who were undergoing isotretinoin treatment.

Data were collected at monthly visits between Nov. 23, 2016, and Jan. 22, 2019.

The primary endpoint included normalized scores for emotional, symptomatic and functional aspects of the Skindex-16 measure.

The cohort was 54.4% male with a median age of 17.2 years. Patients completed the Skindex-16 at baseline and at least once during follow-up.

Results from baseline showed that sex had no impact on Skindex-16 scores. However, increasing age was associated with worse baseline Skindex-16 score. Among patients who required isotretinoin treatment, emotional impact was a more significant factor than symptoms or functioning.

At 2 months of treatment with isotretinoin, the researchers observed an improvement greater than 50% in overall Skindex-16, from 39.4 to 17.5 (P < .001).

Further findings showed that Skindex-16 scores were lowest between months 3 and 5 from baseline. Within this interval, patients reported a 77.5% improvement in QOL from baseline.

Looking at the more specific time point of 4 months, at that assessment, a 4.4-fold improvement in Skindex-16 score was observed, from 39.4 at baseline to a nadir of 8.9 (P < .001). Also at 4 months, emotional domain scores improved by a 4.8-fold margin, from 57.7 to a nadir of 11.9 (P < .001).

Data showed substantial variation in each individual’s scores as a function of the group scores, which was attributed to variables that were not assessed by the study. In addition, individual scores fluctuated and did not demonstrate smooth trajectories over time.

While the researchers acknowledged that the findings were limited by the single-center nature of the study, they suggested that patients with acne may reasonably expect a four- to fivefold improvement in QOL after undergoing a full course of treatment with isotretinoin. “This study shows a potential use for routine administration of QOL assessments in informing patient care in dermatology,” they wrote.