To assess the efficacy of isotretinoin in acne vulgaris with daily versus pulse therapy
Keywords:
Isotretinoin, acne vulgarisAbstract
Aim To determine the Efficacy of isotretinoin in acne vulgaris daily versus pulse therapy. Study design A randomized controlled trial. Place and duration of study Outpatient Department of Dermatology, Sargodha Medical College, Sargodha, from June 2017 to July 2018. Methods There were total 150 patients (both male and female) having 75 patients in each group. Group A was given oral isotretinoin capsule 20 mg twice daily for one week after 3 weeks as intermittent/ pulse therapy for 6 months. Group B was given oral isotretinoin capsule 20 mg/daily continuously for 6 months. Group A and B further sub divided into mild, moderate and severe, having 25 patients in each subgroup. The patients were advised to revisit after every 4 weeks for follow-up. Both groups were also advised to apply 1 % clindamycin gel twice a day for 6 months on lesions. The drug is considered efficacious if acne lesion of the patient reduced to 0-5 lesion only. Results In group A, the oral isotretinoin pulse therapy was efficacious in 22 patients (88%) of mild acne, 23 patients (92%) of moderate acne and 19 patients (76%) of severe acne. In group B, the oral isotretinoin continuous therapy was efficacious in 23 patients (92%) of mild acne, 22 patients (88%) of moderate acne and 21 patients (84%) of severe acne. There was no difference in efficacy of drug in mild moderate or severe acne in group A and B as the p – value calculated by One way Anova is 0.091 and 0.098 respectively, which is not significant. It also revealed that there was no statistical difference in efficacy of drug in group A and B , having p value of >0.05. Conclusion It is concluded that the efficacy of oral isotretinoin for acne in intermediate/pulse therapy is same. So, we should prefer intermediate/pulse therapy as it is cost effective, there are reduced side effects of drug due to shorter duration and the patient is more compliant.References
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