Isotretinoin exposure may not increase IBD risk in patients with acne vulgaris
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Risk of inflammatory bowel disease was generally low among individuals with acne vulgaris treated with isotretinoin, according to a study.
“Several reports of new-onset inflammatory bowel disease (IBD) after isotretinoin exposure have led to concern about a potential causal relationship. Although some observational studies have attempted to address this question, there remains a lack of consensus in the literature regarding the association between isotretinoin exposure and the subsequent emergence of IBD,” Shari Wright, BS, of the department of dermatology at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, and colleagues wrote.
In the retrospective cohort analysis, Wright and colleagues aimed to compare 6-month and 1-year IBD risk in isotretinoin-exposed and unexposed patients with acne vulgaris. The cohort was 87% white, with 72% of individuals aged 15 to 29 years.
Looking at crude 6-month incidence rates, IBD occurred in 0.08% of 27,230 isotretinoin-exposed individuals and 0.04% of 631,089 individuals in the unexposed group.
For crude 1-year outcomes, IBD occurred in 0.1% of the isotretinoin-exposed group and 0.08% of unexposed individuals.
Isotretinoin exposure was associated with an 87% increase in risk of developing IBD at 6 months (adjusted OR = 1.87; 95% CI, 1.20-2.93). However, the absolute difference in IBD risk at 6 months was just 2.6 cases per 10,000 patients (95% CI, 0.7-4.5).
At 1 year, adjusted analysis results showed that isotretinoin exposure yielded no significant difference in IBD risk compared with no exposure (OR = 1.40; 95% CI, 0.95-2.05).
Regarding limitations, the researchers suggested that isotretinoin exposure may make any given individual patient more likely to have IBD detected by a health care professional.
“IBD incidence among isotretinoin-exposed patients with [acne vulgaris] is very low, and the risk appears similar to that for unexposed patients with [acne vulgaris],” the researchers wrote. “The use of isotretinoin for the treatment of [acne vulgaris] should be based on a thorough assessment of the risks and benefits for each individual patient.”