MedWire News: A low cumulative-dose isotretinoin treatment regimen for mild-to-moderate acne is effective for inducing stable remission and preventing relapses, report researchers.

A cumulative isotretinoin dose of 120 mg/kg or more has been shown to significantly reduce the chance of a post-treatment relapse in patients with severe acne, but information on the most appropriate cumulative dose for patients with milder cases of the condition is less clear.

Vincenzo Bettoli (University of Ferrara, Italy) and colleagues carried out an open, prospective study in which 139 men and women with mild-to-moderate acne, aged 20.6 years on average, were treated with isotretinoin until completely recovered (cumulative dose), and for an additional month afterwards. Maintenance therapy with adapalene 0.1% cream was carried out for an extra year and the patients were followed up for acne relapse for a further treatment-free year.

The team found that the mean cumulative dose of isotretinoin was 80.92 mg/kg. After 2 years of follow-up, only 13 patients (9.35%) had a relapse of their condition.

"Our findings seem to encourage low cumulative-dose courses of isotretinoin administration in mild-to-moderate acne, as lower cumulative doses may have many advantages for patients and lower costs than standard regimen," write the authors in the Journal of the European Academy of Dermatology and Venereology.

"It is well known that the severity of isotretinoin-induced side effects is dose related. In this respect, lower daily and cumulative doses represent a major therapeutic advance, as they reduce the risk and severity of side-effects and increase patient compliance," they add.

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