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Effects of isotretinoin on bone mineralization during routine therapy with isotretinoin for acne vulgaris
D J Margolis1, M Attie, J J Leyden
1Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, USA.
Objective:
To examine the effects of isotretinoin on bone mineralization and other markers of calcium homeostasis in individuals receiving isotretinoin for routine therapy for severe acne vulgaris.
Design:
Cohort study.
Setting:
An academic medical center.
Patients:
Twenty individuals receiving isotretinoin for severe acne vulgaris.
Intervention:
None.
Main Outcome Measure:
The primary outcome was the change in bone mineralization as measured by dual-energy x-ray absorptiometry of the lumbar spine and hip before and after isotretinoin therapy. Additional measurements included serum osteocalcin, calcium, 25-dihydroxyvitamin D, 1,25-dihydroxyvitamin D, and intact parathyroid hormone and urine hydroxyproline or calcium.
Results:
No changes were noted in bone mineralization of the lumbar spine or hip. Furthermore, no alterations were noted in serum measurements of osteocalcin, calcium, 25-dihydroxyvitamin D, intact parathyroid hormone, or urine measurements of hydroxyproline or calcium. A statistically significant change was noted in 1,25-dihydroxyvitamin D when serum from before and after isotretinoin therapy was compared.
Conclusion:
The use of isotretinoin for 20 weeks for the treatment of severe acne vulgaris does not appear to have any substantial adverse effect on bone mineralization.