scholarly journals Evaluation of musculoskeletal adverse effects in patients on systemic isotretinoin treatment: A cross-sectional study

2021 ◽  
Author(s):  
Emine Müge Acar ◽  
Senem Şaş ◽  
Fatmanur Aybala Koçak
Keyword(s):  
Back Pain ◽  
Side Effects ◽  
Adverse Effects ◽  
Treatment Period ◽  
Acne Vulgaris ◽  
Disease Diagnosis ◽  
Pain Severity ◽  
Pain Group ◽  
Significant Difference ◽  
Vas Scores

Objectives: This study aims to investigate the frequency of musculoskeletal adverse effects in acne vulgaris patients receiving systemic isotretinoin treatment. Patients and methods: Between January 2016 and December 2017, a total of 200 severe acne patients (22 males, 178 females; mean age: 21.8±0.4 years; range, 15 to 53 years) who were on isotretinoin treatment were retrospectively analyzed. Data including age, sex, body mass index (BMI), duration of disease, diagnosis, and comorbidities were recorded. Back pain severity was evaluated with the Visual Analog Scale (VAS). Results: The treatment period was mean 8.5±0.1 (range, 6 to 12) months. The dose of isotretinoin was mean 0.6±0.1 (range, 0.5 and 1) mg/kg. Musculoskeletal side effects were seen in 99 (49.5%) patients. Back pain was reported during the treatment period in 78 (78.7%) patients. The diagnosis was mechanical back pain in 31 (39.7%) and inflammatory back pain in 47 (60.3%) patients. The moderate-severe back pain group received higher cumulative isotretinoin doses than the mild back pain group (p=0.003). The BMI values did not show a significant difference between the patients with and without back pain (p=0.55). There was no significant correlation between the BMI and VAS scores (p=0.06). The VAS scores were found to be correlated with age (p=0.04). Sacroiliitis was diagnosed in four (4%) patients. One (1%) patient was diagnosed with enthesitis. Creatine kinase elevation was reported in 18 (18.1%) patients, while three (3%) patients described myalgia of mild severity. Conclusion: Low back pain is one of the most common musculoskeletal side effects of isotretinoin treatment that usually resolves with dose reduction. The cumulative dose of isotretinoin does not seem to play a role in the development of back pain, but can determine pain severity. Pain severity is directly correlated with the increasing age. Evaluation of the patients for musculoskeletal side effects during isotretinoin use is important in clinical practice, as it is a common occurrence.

scholarly journals Topical Isotretinoin in Acne Vulgaris

2018 ◽  
Vol 29 (2) ◽  
pp. 1-5
Author(s):  
M Moksedur Rahman ◽  
M Abdullah ◽  
M Moazzem Hossain ◽  
MA Siddique ◽  
M Nessa ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Prospective Study ◽  
Acne Vulgaris ◽  
Topical Therapy ◽  
Outpatient Department ◽  
College Hospital ◽  
Once Daily ◽  
Medical College ◽  
Cutaneous Reactions

This study was carried out to evaluate the efficacy, safety and adverse effects of topical isotretinoin 0.05% gel in the treatment of acne vulgaris. This prospective study was undertaken in Skin & VD outpatient department of Rajshahi Medical College Hospital, Rajshahi. One hundred patients with mild tomoderate acne vulgaris were enrolled and were instructed to apply isotretinoin 0.05% gel once daily at night for 12 weeks. Patients were followed up at 2,4,8 and 12 weeks for efficacy and tolerability. Efficacy was measured by counting facial inflammatory and noninflammatory lesions and by grading acne severity. Cutaneous tolerance was assessed by determining erythema, scaling and burning with pruritus.Response was excellent in 80%of cases.None of the cutaneous reactions was severe, all were mild and well tolerated.Nobody had to discontinue the therapy for side effects. This study confirms that isotretinoin 0.05% gel is safe and effective topical therapy for mild to moderate acnevulgaris.TAJ 2016; 29(2): 1-5

scholarly journals The Effect of Systemic Methotrexate and Cyclosporine Combination Therapy inPsoriasis Vulgaris Patients in Bandung, Indonesia

2021 ◽  
Vol 33 (3) ◽  
pp. 200
Author(s):  
Oki Suwarsa ◽  
Fatima Aulia Khairani ◽  
Syawalika Ulya Isneny ◽  
Erda Avriyanti ◽  
Hartati Purbo Dharmadji ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Side Effects ◽  
Adverse Effects ◽  
Combination Therapy ◽  
Combination Treatment ◽  
Psoriasis Vulgaris ◽  
Severity Index ◽  
Dermatology Clinic ◽  
Significant Difference ◽  
Pasi Score

Background: Methotrexate (MTX) and cyclosporine have been used as effective systemic mono-therapy for psoriasis. Several factors are considered to switch monotherapy to combination therapy because monotherapy is no longer effective and has higher side effects. Hence,clinicians have avoided systemic therapy combinations due to its toxicity. However, some studies showed that this combination therapy could be usedeffectively for psoriasis patients. Purpose: This study aimed to analyze the efficacy and adverse effects of systemic MTX and cyclosporine combination therapy in Indonesian psoriasis vulgaris patients. Methods: The retrospective study assessed the effectiveness of 3 monthsmono-therapyand combination therapy of systemic MTX and cyclosporine in psoriasisvulgaris patients from 2016–2017 in Dermatology Clinic, Dr. Hasan Sadikin Hospital, Bandung, West Java, Indonesia. Result: Psoriasis area and severity index (PASI) score 90 were achieved in the group MTX (50%) and cyclosporine group (50%), while none in the combination group.However, eight patients (50%) in group MTX and cyclosporine reached the primary endpoint of PASI 50. One patient in cyclosporine group had adverse effects on kidney profiles. Nonetheless, other patients had no biochemical changes. But, there was no significant difference in the change of PASI between each group (p=0.102). Conclusion: We propose that combination therapy of MTX and cyclosporine is relatively safe and efficacious in treating Indonesian psoriasis vulgaris patients. This combination treatment isas effective as MTX or cyclosporinemono-therapy.

scholarly journals A rational pharmacotherapeutic study of comparative safety among topical anti-acne 1% nadifloxacin monotherapy, 0.1% adapalene monotherapy, 0.025% tretinoin monotherapy, 1% nadifloxacin and 0.1% adapalene combination therapy and 1% nadifloxacin and 0.025% tretinoin combination therapy, in mild to moderate acne vulgaris, in tertiary care hospitals

2019 ◽  
Vol 8 (9) ◽  
pp. 1959
Author(s):  
Moumita Hazra
Keyword(s):  
Adverse Effects ◽  
Combination Therapy ◽  
Acne Vulgaris ◽  
Tertiary Care ◽  
Skin Irritation ◽  
Combination Therapies ◽  
Global Alliance ◽  
Topoisomerase Iv ◽  
Significant Difference ◽  
Anti Inflammatory

Background: Topical adapalene and tretinoin, are comedolytic, anti-comedogenic and anti-inflammatory, on RAR (α, β, γ) receptors binding. Adapalene enables quicker follicular penetration, by lesser anti-AP-1 (c-Jun, c-Fos) and no CRBPII mRNA actions, causing chemical stability, lipophilicity and less photo-lability, producing lesser photosensitivity and no skin irritation, unlike tretinoin; wherein reducible by overnight application and combination therapy, slow-release polymers or emollients, respectively. Topical nadifloxacin is bactericidal, anti-inflammatory and comedolytic, with inhibitory effect on DNA gyrase, DNA topoisomerase IV and IL-1α, IL-6, IL-8. The Global Alliance to Improve Outcomes in Acne Guidelines recommend synergistic and additive combination therapies, which enhance therapeutic efficacy and reduce adverse effects. Due to inadequacy of data, this study was conducted, to compare the safety among topical anti-acne monotherapies and combination therapies, and to easily detect any adverse effect producing component in the topical combination therapy.Methods: In this multi-centre, prospective, randomised, open-labelled, comparative study, groups A, B, C, D and E (20 patients each), applied topical 1% nadifloxacin monotherapy, 0.1% adapalene monotherapy, 0.025% tretinoin monotherapy, 1% nadifloxacin and 0.1% adapalene combination therapy and 1% nadifloxacin and 0.025% tretinoin combination therapy, respectively, over their facial mild to moderate acne lesions, once daily overnight; and adverse effects, like erythema, scaling, dryness, prutitus, burning, or stinging, were assessed on 0, 15, 30, 60, 90 days and follow-ups, by Local Irritation Scale.Results: In all 5 groups, no adverse effects were observed, with no statistically significant difference among the observations.Conclusions: The therapies were well tolerated and safe among all 5 groups.

scholarly journals Analyzing the Influence of Modic Changes on Patients with Lower Back Pain Undergoing Conservative Treatment

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Yufeng Chen ◽  
Huilin Yang ◽  
Lianfang Zhang ◽  
Yue Wang ◽  
Jun Zou
Keyword(s):  
Back Pain ◽  
Lower Back Pain ◽  
Modic Changes ◽  
Nonsurgical Treatment ◽  
Type I ◽  
Type Ii ◽  
Lower Back ◽  
Significant Difference ◽  
Modic Type ◽  
Vas Scores

Objective. This study aimed to investigate if the presence of Modic changes (MCs) was correlated with lower back pain (LBP) and LBP-related disability in patients who underwent nonsurgical treatment. Methods. In this study, 129 patients who experienced consecutive LBP and underwent lumbar spine magnetic resonance imaging in our institute were divided into three groups according to the presence or type of MCs. The Oswestry Disability Index (ODI) and visual analog scale (VAS) were used to assess the outcomes of the treatment. Results. Based on the achieved results, there was no significant difference between three groups before treatment (P>0.05). Three months after undergoing nonsurgical treatment, the rates of improved ODI and VAS scores were statistically significantly different (P=0.014,  0.023). After an additional 3 months of treatment, in patients with Modic type I changes, the symptoms significantly improved in comparison with those 3 months prior (P=0.037,  0.026), while that improvement did not occur in patients with Modic type II changes (P>0.05). Conclusions. The existence of MCs affects the outcomes of nonsurgical treatment in patients with LBP. However, symptoms can be improved after an additional round of treatment for Modic type I changes, while this is not confirmed for Modic type II changes.

Study of the Feasibility of Conventional MR Images and Magnetic Resonance (MR)/Ultra-Short Echo Time (UTE) Technique in the Evaluation of Lumbar Disc Degeneration in the Axial Plane

2021 ◽  
Vol 11 (3) ◽  
pp. 817-821
Author(s):  
Peng Tang ◽  
Jingtao Xu ◽  
Wei Liu ◽  
Yu Li ◽  
Wei Fan ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Intervertebral Disc ◽  
Disc Degeneration ◽  
Intervertebral Disc Degeneration ◽  
Structural Integrity ◽  
Low Back ◽  
Pain Group ◽  
Cartilage Endplate ◽  
Significant Difference

The advantage and value of magnetic resonance (MR)-ultra-short echo time (UTE) technique in the displaying the structures of degenerative intervertebral discs were observed through evaluating the lumbar disc degeneration in the axial plane by conventional MR image and MR-UTE technique. A total of 160 examinees screened by inclusion and exclusion criteria were enrolled, and a total of 800 intervertebral disks were involved, and the degree of intervertebral disc degeneration was classified by conventional MR image classification method. After the first echo image of MR-UTE technique was integrated with the contour, the image entered UTE cartilage endplate, fibrous ring and osseous endplate. The integrity of the intervertebral disc from the above and below the intervertebral disc and the correlation of the structural endplate with the integrities of cartilage endplate, fibrous ring and osseous endplate under double echo sequence were analyzed, and the correlation analysis of the two categorical variables was conducted using rank correlation analysis. Under the MR-UTE sequence, there was no statistical significant difference in structural integrity constituent ratio (intact structure only on one side, incomplete structure on both side) between the non-low back pain group and the low back pain group (P > 0.05), the proportion of complete structure disappearance was lowest, and the proportion of partial structure disappearance was highest; there was a significant difference in the structural integrity of fibrous ring between the non-low back pain group and the low back pain group (P < 0.05), there was a statistical significant difference in structural integrity of fibrous rings between the two groups (P < 0.05); there was a statistical significant difference in pain degree between the partial structure disappearance group and the complete structure disappearance group (P < 0.05). There was no significant difference in pain degree between the groups (intact structure only on one side and incomplete structure on both side); conventional MR images showed no significant difference in the intervertebral disc degeneration degree between the non-low back pain group and low back pain group (P > 0.05), and the intervertebral disc degeneration degree had no significant correlation with the lower back pain. MR-UTE sequence and T2WI sequence showed that there was a correlation between different intervertebral disc degeneration degrees and the structural integrity distributions of cartilage endplate, osseous endplate and fibrous rings in two groups of patients with or without low back pain (P < 0.05). Whether low back pain exists or not has little effect on the intervertebral disc degeneration degree on T2WI. MR-UTE double echo sequence scan reveals that the intervertebral disc degeneration degree is positively related to the integrity and integrity distribution of cartilage endplate, fibrous ring and bone endplate.

scholarly journals Comparative clinical study of efficacy and safety of adapalene 0.1% gel versus benzoyl peroxide 2.5% gel for the treatment of acne vulgaris

2019 ◽  
Vol 8 (10) ◽  
pp. 2317
Author(s):  
Anuradha Dubey ◽  
Hanmant Amane
Keyword(s):  
Side Effects ◽  
Benzoyl Peroxide ◽  
Acne Vulgaris ◽  
Total Duration ◽  
The Other ◽  
Efficacy And Safety ◽  
Inflammatory Lesions ◽  
Significant Difference ◽  
Comparative Clinical Study ◽  
Topical Treatments

Background: Acne vulgaris is characterised by comedones, papules, pustules and nodules occurring in a sebaceous distribution. Topical treatments, such as adapalene and benzoyl peroxide, are popular in mild to moderate acne vulgaris. This study was aimed to compare the efficacy and safety of adapalene with benzoyl peroxide in the patients of mild to moderate acne vulgaris.Methods: We planned a randomized, open-labelled, prospective study to compare the efficacy and side effects of adapalene and benzoyl peroxide in acne patients. A total of 100 patients with mild to moderate acne vulgaris were included in the study. They were randomly divided into 2 groups with 50 patients in each group. One group was given 0.1% adapalene gel and the other group received 2.5% benzoyl peroxide gel. Efficacy was assessed as reduction in the lesion counts, whereas for safety, the side effects like dryness, burning, irritation, erythema were recorded during the treatment. Total duration of the study was 3 months.Results: The study revealed that adapalene was more effective than benzoyl peroxide in treating non-inflammatory and inflammatory lesions of acne vulgaris, and there was a statistically significant difference found between the groups (p≤0.05) in efficacy. Adapalene was also found to be comparatively safer than benzoyl peroxide because the patients treated with adapalene had lesser side effects than those treated with benzoyl peroxide.Conclusions: Our study concludes a better efficacy and safety of adapalene than benzoyl peroxide in the treatment of mild to moderate acne vulgaris.

scholarly journals Topical Clindamycin in the Treatment of Acne Vulgaris

KYAMC Journal ◽  
2013 ◽  
Vol 1 (2) ◽  
pp. 59-64
Author(s):  
Shahnaj Sultana ◽  
Md. Nure Alom Siddiqul ◽  
Md. Moksedur Rahman ◽  
Muhammad Afsar Siddiqul ◽  
Abdullah Al Amin
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Prospective Study ◽  
Acne Vulgaris ◽  
Topical Therapy ◽  
Clindamycin Phosphate ◽  
College Hospital ◽  
Patient Response ◽  
Medical College ◽  
Continued Use

This study was conducted to evaluate the efficacy, safety and adverse effects of topical clindamycin phosphate 1% lotion in treating acne vulgaris in a group of Bangladeshi people. This prospective study was undertaken in skin & VD out patient department of Rajshahi Medical college Hospital, Rajshahi. A total of 30 patients, 15 (50%) males and 15 (50%) females between ages 15 and 35 years (mean 18 years) with acne of grades I, II and III of duration <3 years to 10 years (mean 3.33 years) were studied. Clindamycin phosphate 1% lotion was administered twice daily for 12 weeks to each patient. Response was excellent in 73.33%, good in 20%, fair in 3.33% and poor in 3.33% of cases. Clinical adverse effects were noted in 20% of cases where oiliness was in 6.67%, irritation and burning in 3.33%, puritans in 3.33%, erythema i3.33% and peeling in 3.33% of cases. None of the reactions was severe, all were mild and well tolerated and most occurred within the first month of initiation of treatment and resolved with continued use of drug and completely cured after the treatment completed. No body had to discontinue the therapy for side effects. 80% of the total patients had no side effects. This study confirms that clindamycin is safe and effective topical therapy for mild to moderate acne vulgaris.DOI: http://dx.doi.org/10.3329/kyamcj.v1i2.13316KYAMC Journal Vol.1(2) January 2011, 59-64

scholarly journals Is Oral Omega-3 Effective in Reducing Mucocutaneous Side Effects of Isotretinoin in Patients with Acne Vulgaris?

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Mina Mirnezami ◽  
Hoda Rahimi
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Acne Vulgaris ◽  
Control Group ◽  
Case Group ◽  
Omega 3 ◽  
Double Blind ◽  
Severe Acne ◽  
Double Blind Clinical Trial ◽  
And Control

Background. Acne vulgaris is an inflammatory disease of pilosebaceous units which may cause permanent dyspigmentation and/or scars if not treated. Isotretinoin is recommended in the treatment of recalcitrant or severe acne, but it is associated with common adverse effects that frequently result in patients incompliance and discontinuation of the drug. The present study was designed to assess the efficacy of oral omega-3 in decreasing the adverse effects of isotretinoin. Materials and Methods. In this randomized double-blind clinical trial, a total of 118 patients with moderate or severe acne were randomly divided into two (case and control) groups. The control group was treated with isotretinoin 0.5 mg/kg, and the case group was treated with the same dose of isotretinoin combined with oral omega-3 (1 g/day). The treatment was lasted for 16 weeks and mucocutaneous side effects of isotretinoin were recorded and compared between the two groups in weeks 4, 8, 12, and 16. Results. Cheilitis (at weeks 4, 8, and 12), xerosis, dryness of nose at all weeks, and dryness of eyes (at week 4) were less frequent in the group that received isotretinoin combined with oral omega-3 compared to the group that received isotretinoin alone. Conclusion. Administration of oral omega-3 in acne patients who are receiving isotretinoin decreases the mucocutaneous side effects of isotretinoin. This trial is registered with  IRCT201306238241N2.

scholarly journals Rational Pharmacotherapy in Case of Exacerbation of the Primary Low Back Pain

2021 ◽  
pp. 51-58
Author(s):  
Oleksandr Burianov ◽  
Taras Omelchenko ◽  
Volodymyr Volodymyr ◽  
Myroslav Myroslav ◽  
Volodymyr Lianskorunskyi
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Study ◽  
Side Effects ◽  
Conservative Treatment ◽  
Diclofenac Sodium ◽  
Main Group ◽  
Low Back ◽  
Significant Difference ◽  
Daily Dose

Low back pain (LBP) is one of the most common causes of orthopedic disability in people under 45 years of age. Primary LBP accounts for more than 90 % of all cases. The main objectives of treatment are to slow the progression of the degenerative process, reduce the intensity of inflammation and pain, increase functional activity and quality of life of patients. The solution of the set tasks is impossible without effective complex influence on numerous links of pathogenesis of degenerative-dystrophic and inflammatory process and ensuring safety at treatment. The objective: to evaluate the clinical effectiveness of complex conservative treatment of primary LBP with the use of the drug Alsokam (meloxicam) in patients with uncomplicated forms of degenerative-dystrophic lesions of the spine in the period of exacerbation. Materials and methods. A non-randomized, prospective comparative clinical study in two parallel groups involved 30 patients with exacerbation of LBP on the background of uncomplicated forms of degenerative-dystrophic lesions of the spine (osteochondrosis, spondyloarthritis). The mean age of patients was 40±7,2 years. There were 12 (40 %) female patients and 18 (60 %) male patients. The main group consisted of 15 patients who were prescribed the drug Alsokam (meloxicam) at a dose of 15 mg 1 time per day intramuscularly for 7 days. The control group consisted of 15 patients who received diclofenac sodium at a traditional daily dose of 75 mg intramuscularly once daily for 7 days during the same treatment period. In both groups, tolperisone 150 mg 3 times a day and B vitamins were also used for 10 15 days. Outcome evaluation parameters included: Visual analog pain scale (VAS), Huskisson; assessment of the patient’s functional status on the Roland-Morris scale (RDQ-24); accounting for side effects and adverse events in the observation groups. Results. In both groups, a significant decrease in the intensity of the pain syndrome was observed in the assessment of pain by VAS, but no statistically significant difference was observed between the observation groups (p=0,312). The analysis of the results of the evaluation of RDQ-24 also showed an increase in functional capacity in both groups, but without a significant difference between the groups of clinical observation (p=0,302). Analysis of the number of undesirable side effects in the observation groups showed a significantly lower frequency in patients of the main group with a high statistical probability (p<0,01). Conclusions. The results of a clinical study showed the effectiveness of meloxicam (Alsokam) in the complex conservative treatment of patients with primary LBP in the period of exacerbation, which correlates with the effect of diclofenac sodium in the average daily dose. The nature and frequency of adverse reactions in the main and comparator groups showed that meloxicam in Alsocam has a significantly higher safety profile compared to diclofenac sodium, and its use in complex treatment regimens for patients with primary LBP syndrome reduces the risk of NSAIDs gastropathies.

scholarly journals Investigation of the Frequency of Adverse Effects in Patients Treated with Favipiravir as SARS-CoV-2 Treatment

2021 ◽  
pp. 1-4
Author(s):  
Ebru Dogan ◽  
Sevil Alkan-Çeviker ◽  
Servan Vurucu ◽  
Alper Sener ◽  
Buse Yüksel ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Demographic Data ◽  
Antiviral Agents ◽  
Good Alternative ◽  
Long Term Effects ◽  
Cardiac Side Effects ◽  
Significant Difference ◽  
Gastrointestinal Side Effects ◽  
Treatment Agent

Objective: For 2019 and 2020, SARS-CoV-2 has been a sensational virus. Unfortunately, a treatment agent specific for SARS-CoV-2 has not been developed yet. Favipiravir is one of the antiviral agents used experimentally in the treatment of SARS-CoV-2. This study aimed to determine the frequency of side effects seen in patients hospitalized in our hospital and received favipiravir at any stage of their treatment. Methods: Our study is a retrospective observational study. Definite and probable COVID-19 cases hospitalized in our hospital between March 23, 2020, May 31, 2020, were determined, and those receiving favipiravir as initial or secondary therapy were included in the study. The demographic data, laboratory tests, observed side effects of the patients were recorded and analyzed statistically. Results: A total of 134 patients, 37.3% using favipiravir at the beginning and 62.7% as secondary, were included in the study. The mean age of the patients was 66.8±15.7 years. 38.1% (n=51) of the group were female. Side effects were detected in 17 (13%) patients in the whole group. Hepatotoxicity (4.5%), increased serum uric acid (4.5%), nephrotoxicity (1.5%), gastrointestinal side effects (1.5%), cardiac side effects (0.7%) were detected. There was no statistically significant difference in terms of adverse events between the patients who received favipiravir initially or later on disease course. Conclusions: Although some results support the short-term safety of favipiravir, more studies are needed for its long-term effects. Studies on hyperuricemia, QTc prolongation, use in pregnancy, use during lactation and use in children are insufficient. Therefore, although Favipiravir appears to be a good alternative in the treatment of COVID-19, it should be used carefully because the data on its safety is still insufficient. Key Words: Favipiravir, adverse effects, COVID-19, SARS-CoV-2

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