The following is a summary of “Isotretinoin and the risk of inflammatory bowel disease and irritable bowel syndrome: A large-scale global study,” published in the APRIL 2023 issue of Dermatology by Kridin, et al.

The relationship between isotretinoin and inflammatory bowel disease has been a topic of debate for a long time. However, little information was available on the incidence of isotretinoin-related irritable bowel syndrome. Therefore, for a study, researchers sought to assess the risk of developing Crohn’s disease, ulcerative colitis, and irritable bowel syndrome in patients with acne treated with isotretinoin compared to those treated with oral antibiotics.

A retrospective cohort study was conducted on a global population, where patients with acne were divided into two groups: those treated with isotretinoin (n=77,005) and those treated with oral antibiotics (n=77,005). 

The study utilized comprehensive propensity-score matching. The study found that the lifetime risk of Crohn’s disease (HR 1.05; 95% CI, 0.89-1.24; P=.583) and ulcerative colitis (HR 1.13; 95% CI, 0.95-1.34; P=.162) was similar in both groups. However, the lifetime risk of irritable bowel syndrome was lower in patients prescribed isotretinoin (HR 0.82; 95% CI, 0.76-0.89; P<.001). Time-stratified analysis showed that the risk of developing ulcerative colitis was significantly higher in patients taking isotretinoin during the first six months of treatment (HR 1.93; 95% CI, 1.29-2.88; P=.001). However, this risk decreased over time and eventually leveled with the risk in the comparator group. The absolute risk difference within the first six months was clinically insignificant (5.0 additional cases of ulcerative colitis per 10,000 patients starting isotretinoin; 95% CI, 2.5-7.7).

In conclusion, isotretinoin treatment does not appear to increase the risk of Crohn’s disease. However, there may be a slight and temporary increase in the risk of developing ulcerative colitis.

Reference: jaad.org/article/S0190-9622(22)03304-7/fulltext