Consensus Statements on the Use of Novel Formulations of Isotretinoin:A Modified Delphi Process

Paige Kingston, Leon Kircik, Neal Bhatia, James Q. Del Rosso, Seemal R. Desai, Julie C. Harper, Linda Stein Gold, Firas Hougeir, April W. Armstrong

Research output: Contribution to journalArticlepeer-review

Abstract

Oral isotretinoin remains a mainstay of treatment for severe, recalcitrant nodular acne. Novel formulations of isotretinoin have been developed over the past decade, including lidose isotretinoin and micronized isotretinoin. It is important to understand the differences between isotretinoin formulations to help guide clinical decision-making and selection of isotretinoin therapy.This study aims to provide evidence-based consensus statements regarding the use of novel formulations of isotretinoin for the treatment of moderate-to-severe acne. The Expert Consensus Group consisted of dermatologists Do Not with Copy expertise in the treatment of acne. Voting members met in person to conduct a modified Delphi process; a maximum of 2 rounds of voting were conducted for each consensus statement. A total of 5 statements were generated regarding the use of novel formulations of isotretinoin, addressing the efficacy, tolerability, and side effects of novel isotretinoin formulations. All 5 statements achieved agreement with high consensus. The Expert Consensus Group agrees that individualized selection of isotretinoin therapy is important to maximize efficacy and minimize side effects. Compared to generic isotretinoin, micronized isotretinoin may require lower doses to achieve sufficient plasma concentrations. With the increased bioavailability of micronized formulation, there is no need to calculate cumulative dose; instead, the general recommendation with micronized isotretinoin is to treat for at least 5 months, or longer if needed to achieve clearance. Micronized isotretinoin can be taken in the fed or fasted state and has an acceptable safety profile.

Original languageEnglish (US)
Pages (from-to)429-432
Number of pages4
JournalJournal of Drugs in Dermatology
Volume23
Issue number6
DOIs
StatePublished - Jun 2024

ASJC Scopus subject areas

  • General Medicine

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