VARIATIONS IN LIPID AND LIPOPROTEIN LEVELS DURING ISOTRETINOIN TREATMENT FOR ACNE-VULGARIS WITH SPECIAL EMPHASIS ON HDL-CHOLESTEROL

Background Many studies have demonstrated an increase in total cholest erol and triglycerides on oral isotretinoin therapy. This has led seve ral investigators to comment on the possibility of increased risk for cardiovascular disease. Yet, the status of high density lipoprotein (H DL) in patients on isotretinoin therapy has not been studied extensive ly. Patients and methods We studied 104 United Arab Emirates (UAE) nat ionals (78 women, 26 men) who underwent isotretinoin therapy for acne at doses ranging from 0.2 to 1.6 mg/kg, and determined the lipid and l ipoprotein levels before and after an 8-week period of treatment. The risk for cardiovascular disease was evaluated as the ratio of choleste rol/HDL-cholesterol. Results Mean cholesterol, triglycerides, and low density lipoprotein-cholesterol (LDL-cholesterol) levels rose signific antly after treatment (p=0.01) whereas HDL-cholesterol Values decrease d significantly (p=0.01). in the entire subject population, the overal l risk for cardiovascular disease rose from 3.45 to 3.67, indicating t hat these subjects remained in the category considered to have ''half- average'' to ''average'' risk of cardiovascular disease. Conclusions I n young and healthy individuals, significant variations in lipid and l ipoprotein levels, resulting from isotretinoin treatment for acne, do not influence the overall risk for cardiovascular disease. Isotretinoi n is thus a safe and efficient drug for the treatment of acne in these subjects.