Abstract：
The optimal frequency and timing of laboratory monitoring during isotretinoin treatment remains controversial. We aimed to investigate the frequency, timing, and severity of abnormal results during isotretinoin for acne. We conducted a retrospective cohort study comprising 444 acne patients prescribed isotretinoin at Boston Medical Center from 2004 to 2017; these patients had at least one available baseline laboratory result. We categorized patients into two groups: group A (normal values at baseline and during the first 2 months of isotretinoin therapy) and group B (abnormal values at baseline or during the first 2 months of isotretinoin therapy) and assessed the laboratory values after 2 months. The frequency of abnormal results for triglycerides, cholesterol, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) after 2 months for patients in group A was 21.1%, 13.6%, 8.8%, and 6.0%, respectively, with very rare grade 2 (moderate) or higher abnormalities. In contrast, the frequency of abnormal results for patients in group B for triglycerides, cholesterol, AST, and ALT was higher at 67.9%, 88.0%, 40.0%, and 25.0%, respectively (P < 0.05, except for ALT). No patient developed higher than grade 1 (mild) complete blood count (CBC) abnormality. This study proposed that healthy patients with normal results at baseline and during the first 2 months of isotretinoin therapy might not need routine monitoring after month 2 of medication. Routine monitoring of CBC is not necessary.
摘要：
异维甲酸治疗期间实验室监测的最佳频率和时机仍存在争议。我们的目的是调查频率，定时,以及异维A酸治疗痤疮期间异常结果的严重程度。我们进行了一项回顾性队列研究，包括2004年至2017年在波士顿医学中心处方异维甲酸的444名痤疮患者；这些患者至少有一个可用的基线实验室结果。我们将患者分为两组：A组（基线和异维甲酸治疗前2个月的正常值）和B组（基线或异维甲酸治疗前2个月的异常值），并在2个月后评估实验室值。甘油三酯异常结果的频率，胆固醇,天冬氨酸转氨酶（AST），A组患者术后2个月的丙氨酸转氨酶(ALT)为21.1%,13.6%,8.8%,和6.0%，分别,非常罕见的2级（中度）或更高的异常。相比之下,B组患者甘油三酯异常结果的频率，胆固醇,AST,ALT高于67.9%，88.0%,40.0%,和25.0%，（P<0.05，ALT除外）。没有患者出现高于1级(轻度)全血细胞计数(CBC)异常。这项研究表明，在基线和异维甲酸治疗的前2个月内结果正常的健康患者可能不需要在用药2个月后进行常规监测。CBC的常规监测是不必要的。
