Lipid Levels Rise More Than Thought After Acne Treatment

Elevations higher than observed in previous studies

MONDAY, Aug. 21 (HealthDay News) -- About 40 percent of patients taking isotretinoin to treat acne develop elevated triglycerides and about 30 percent develop high cholesterol, higher than previous estimates but transient and reversible in most cases, according to a study in the August issue of Archives of Dermatology.

Lee T. Zane, M.D., of the University of California, San Francisco, and colleagues analyzed the incidence of abnormal laboratory test results in 13,772 patients with acne who underwent oral isotretinoin treatment between 1995 and 2002. The authors noted that the package insert provided with Accutane (Roche) cites elevated serum triglyceride levels in about 25 percent of patients and elevated liver enzymes in 15 percent, and other studies have reported elevated triglyceride levels in 5 percent to 18 percent of patients and elevated total cholesterol levels in 6 percent to 32 percent.

The researchers found that in those with normal values at baseline, 44 percent developed elevated triglycerides, 31 percent developed high total cholesterol, and 11 percent developed elevated, but generally mild, transaminase. The elevations were transient and reversible in most patients. There were few abnormalities in white blood cell or platelet counts or hemoglobin levels, according to the study.

"The incidence of abnormally high serum lipid levels during isotretinoin treatment may be greater than previously estimated," Zane and colleagues concluded. Though this study did not examine clinical outcomes, they noted that other studies have found that "patients with acne who develop large increases in triglyceride levels during isotretinoin therapy are at increased risk for future hyperlipidemia and the metabolic syndrome."

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