Abnormal liver function tests in acne patients receiving isotretinoin

Area of Science:

• Dermatology
• Hepatology
• Pharmacology

Background:

• Isotretinoin is a key treatment for severe acne.
• Mild liver enzyme elevation is a known side effect of isotretinoin.
• Current monitoring guidelines for acne patients on isotretinoin are not well-defined.

Purpose of the Study:

• To evaluate the management and clinical outcomes of acne patients experiencing abnormal liver enzymes (AST and ALT) during isotretinoin treatment.
• To assess the clinical significance of mild aspartate transaminase (AST) and alanine aminotransferase (ALT) elevations in patients undergoing isotretinoin therapy for acne.

Main Methods:

• Retrospective chart review of acne patients with abnormal AST and ALT levels while on isotretinoin.
• Liver enzyme abnormalities were graded using the Common Terminology Criteria for Adverse Events version 5.

Main Results:

• Out of 108 subjects with abnormal liver enzymes, most were on isotretinoin 80mg or 40mg.
• The majority of abnormalities occurred within the first month of therapy.
• Many Grade 1 AST and ALT elevations normalized or persisted without worsening despite dose maintenance.

Conclusions:

• Mild elevations in liver enzymes during isotretinoin therapy for acne typically do not progress.
• Acne patients with low-grade liver enzyme abnormalities may not require continuous laboratory monitoring.