Comparison of efficacy of fixed low-dose regimens (daily vs alternate day) of oral isotretinoin in mild to moderate acne vulgaris
DOI:
https://doi.org/10.66344/jpad.v25i4.149Keywords:
Acne vulgaris, isotretinoin, efficacyAbstract
Objective To compare the efficacy of alternate day fixed low-dose regimen of isotretinoin (20mg) with daily low-dose regimen in mild to moderate acne vulgaris.
Methods Sixty patients of mild to moderate acne vulgaris were divided into two groups A and B, each having 30 patients. In group A patients, oral Isotretinoin 20mg/day was used. In group B patients, oral isotretinoin 20 mg on alternate days was given. Both regimens were continued for six months. The disease severity was assessed by Global Acne Grading System. Patients were followed up monthly and their GAGS scores were calculated at each visit. Percentage decrease in GAGS score at the end of six months was taken as efficacy.
Results The mean age of the patients was noted as 20.72±4.06 years. There were 4 (7%) male patients whereas 56 (93%) patients were females. The mean weight of the patients was noted as
57.88±7.36 kg. In daily dose group, the mean percentage decrease in GAGS was 73.95±14.04 whereas in alternate day group, the mean percentage decrease in GAGS was 66.57±14.97 (P>0.05). In daily dose group, efficacy was achieved in 27 (90%) patients whereas in alternate dose group, efficacy recorded was in 26 (86.7%) patients (P>0.05).
Conclusion In the management of mild to moderate acne vulgaris, the alternate day low-dose isotretinoin has almost equal efficacy as compared to daily low-dose therapy.
References
1. Layton AM, Disorders of the pilosebaceous glands. In: Burns T, Cox N, Breathnach S, Christopher GC, editors. Rook’s Textbook of Dermatology. 8th ed. London; 2010 p. 42.17-27.
2. Barratt H, Hamilton F, Car J et al. Outcome measures in acne vulgaris: systematic review. Br J Dermatol. 2009;160:132-6.
3. Ali G, Mehtab K, Sheikh ZA et al. Beliefs and perceptions of acne among a sample of students from Sindh Medical College, Karachi. J Pak Med Assoc. 2010;60:51-4.
4. Shazia M, Afzal M, Aftab M et al. Precipitating factors of acne vulgaris in females. Ann Pak Inst Med Sci. 2009;5:104-7.
5. Strauss JS, Krowchuk DP, Leyden JJ et al. Guidelines of care for acne vulgaris management. J Am Acad Dermatol. 2007;56:651-63.
6. Sardana K, Garg VK. Efficacy of low-dose isotretinoin in acne vulgaris. Indian J Dermatol Venereol Leprol. 2010;76:7-13.
7. Akman A, Durusoy C, Senturk M et al. Treatment of acne with intermittent and conventional isotretinoin: a randomized, controlled multicenter study. Arch Dermatol Res. 2007;299:467-73.
8. Kaymak Y, Ilter N. The effectiveness of intermittent isotretinoin treatment in mild or moderate acne. J Eur Acad Dermatol Venereol. 2006;20:1256-60.
9. Agarwal US, Besarwal RK, Bhola K. Oral isotretinoin in different dose regimens for acne vulgaris: a randomized comparative
trial. Indian J Dermatol Venereol Leprol. 2011;77:688-94.
10. Rademaker M. Adverse effects of isotretinoin: A retrospective review of 1743 patients started on isotretinoin. Aus J Dermatol. 2010;51:248-53.
11. Amichai B, Shemer A, Grunwald MH. Low-dose isotretinoin in the treatment of acne vulgaris. J Am Acad Dermatol. 2006;54:644-6.
12. Lee JW, Yoo K, Park K et al. Effectiveness of conventional, low-dose and intermittent oral isotretinoin in the treatment of acne: a randomized, controlled comparative study. Br J Dermatol. 2011;164:1369-75.
13. Sardana K, Garg V, Sehgal V et al. Efficacy of fixed low◻dose isotretinoin (20 mg, alternate days) with topical clindamycin gel in moderately severe acne vulgaris. J Eur Acad Dermatol Venereol. 2009;23:556-60.
14. Plewig G, Dressel H, Pfleger M et al. Low dose isotretinoin combined with tretinoin is effective to correct abnormalities of acne. J Dtsch Dermatol Ges. 2004;2:31-45.
15. Mandekou L, Delli F, Teknetzis A et al. Low-dose schema of isotretinoin in acne vulgaris. Int J Clin Pharmacol. 2003;23:41-6.
16. Adityan B, Kumari R, Thappa DM. Scoring systems in acne vulgaris. Indian J Dermatol Venereol Leprol. 2009;75:323-6
17. Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systems and proposal of a novel system. Int J Dermatol. 1997;36:416-8.
18. Goulden V, Layton AM, Cunliffe WJ. Current indications for isotretinoin as a treatment for acne vulgaris. Dermatology. 1995;190:284-7.
19. Goulden V, Clark S, McGeown C, Cunliffe
W. Treatment of acne with intermittent isotretinoin. Br J Dermatol. 1997;137:106-8.
20. Rao PK, Bhat RM, Nandakishore B et al. Safety and efficacy of low-dose isotretinoin in the treatment of moderate to severe acne vulgaris. Indian J Dermatol. 2014;59:316.
21. Kapadia FN, Khalid G, Burhany T, Nakhoda T. Comparative efficacy and safety of systemic 13-cis retinoic acid 20mg/day vs 40 mg/day in acne vulgaris. J Pak Assoc Dermatol. 2005;15:238-41.
Downloads
Published
Issue
Section
License
Copyright (c) 2016 Saira Niazi, Atif Shehzad
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submission declaration
Authors retain the copyright to their work and grant the 'Journal of Pakistan Association of Dermatologists (JPAD)' the right of first publication under a Creative Commons Attribution 4.0 International (CC BY 4.0) license. This license allows others to share, adapt, and reuse the work for any purpose, including commercial use, as long as appropriate credit is given to the original authors and the journal.
By submitting a manuscript, authors confirm that the work has not been published previously (except as an abstract, lecture, or academic thesis), is not under review elsewhere, and has been approved by all authors and relevant authorities. Once accepted, the article will be openly accessible under the CC BY 4.0 license, ensuring wide dissemination and reuse with proper attribution.
