Comparison of safety and efficacy of low dose isotretinoin versus the conventional dosing regime in the treatment of acne vulgaris

Abstract

Background Isotretinoin is a derivative of retinol used in the treatment of acne vulgaris. Treatment with isotretinoin may cause many adverse effects. Objective To compare the efficacy and safety of low dose isotretinoin with the conventional dosing regimen in the treatment of acne vulgaris. Methods This randomized controlled trial study was conducted in the Department of Dermatology Nishtar Hospital Multan form 1st June 2018 to 30th November 2018. A total of 140 patients of both gender with acne vulgaris were included in the study and divided into two groups of 70 sample size by randomization. In group A patients oral isotretinoin 20mg/day and in group B 80mg/day was given for 12 weeks. Final evaluation of efficacy was done after 12 weeks of treatment in both groups. Efficacy and safety was noted. Results Age range in this study was from 15 to 40 years with mean age of 25.114±4.14 years in Group A  while 26.171±3.71 years in Group B. Mean duration of complain was 11.557±4.43 months in Group A  and 11.242±4.38 months in Group B. Mean weight was 62.942±6.42 kg in group A and  62.285±6.01 kg in group B. Mean height was 1.584±0.06 meters in group A and  1.588±0.07 meters in group B. Mean BMI was 25.210±3.33 Kg/m2 in Group A  and 24.851±3.44 Kg/m2 in Group B and mean baseline GAGS score was 25.914±2.04 in Group A  and 26.014±2.88 in Group B. In both groups majority of patients belonged to 15-30 years age group. In both groups majority of patients were female. Efficacy was seen in 50% patients in Group A as compare to 71.4% in Group B (p=0.009). Dry eyes was seen in 31.4% patients in Group A as compare to 42.9% in Group B (p=0.161). Headache was seen in 14.3% patients in Group A as compare to 17.1% in Group B (p=0.642). Conclusion Conventional dosing regimen has more efficacy but less safety than low dose isotretinoin in the treatment of acne vulgaris.