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Vulvo-vaginal candidiasis associated with acitretin
M C Sturkenboom1, A Middelbeek, L T de Jong van den Berg
1Groningen Institute for Drug Studies, Department Social Pharmacy and Pharmacoepidemiology, University Centre for Pharmacy, The Netherlands.
Journal of Clinical Epidemiology
|August 1, 1995
Summary
Acitretin use significantly increases the risk of vulvo-vaginal candidiasis (VVC) in women. This study found a higher occurrence of VVC linked to acitretin exposure, suggesting the drug is a contributing factor.
Area of Science:
- Dermatology
- Pharmacovigilance
- Epidemiology
Background:
- Acitretin is a retinoid used for dermatological conditions.
- Vulvo-vaginal candidiasis (VVC) is a common fungal infection.
- The association between acitretin use and VVC risk requires investigation.
Purpose of the Study:
- To estimate the risk of vulvo-vaginal candidiasis (VVC) in women using acitretin.
- To determine if acitretin exposure is associated with an increased incidence of VVC.
Main Methods:
- A cohort study of 196 women aged 15-45 exposed to acitretin.
- Prescription data for VVC treatment drugs used as a proxy for VVC occurrence.
- Incidence rate ratios and patient-stratified logistic regression analysis were employed.
- Validation of the VVC proxy drug through record linkage achieved high sensitivity and specificity.
Main Results:
- The crude incidence rate ratio for VVC following acitretin exposure was 2.8.
- The pooled Mantel-Haenszel incidence rate ratio was 3.3 after stratification.
- Patient-stratified analysis revealed an odds ratio of 6.5 for VVC in cases.
Conclusions:
- This study provides strong evidence that acitretin exposure is attributable to the higher occurrence of vulvo-vaginal candidiasis.
- Healthcare providers should be aware of this potential side effect in patients using acitretin.
- Further research may explore the mechanisms behind this drug-induced VVC.