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Gerhardy L, Nassar N, Litchfield M, Kennedy D, Smith A, Gillies MB, Pearson SA, Zoega H, Shand A. Prescription retinoid and contraception use in women in Australia: A population-based study. Australas J Dermatol 2024. [PMID: 38693687 DOI: 10.1111/ajd.14294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND/OBECTIVES Oral retinoids are teratogenic, and pregnancy avoidance is an important part of retinoid prescribing. Australia does not have a standardised pregnancy prevention programme for women using oral retinoids, and the contraception strategies for women who use oral retinoids are not well understood. The objectives were to determine trends in the use of prescription retinoids among Australian reproductive-aged women and whether women dispensed oral retinoids used contraception concomitantly. METHODS This was a population-based study using Australian Pharmaceutical Benefits (PBS) dispensing claims for a random 10% sample of 15-44-year-old Australian women, 2013 - 2021. We described rates and annual trends in dispensing claims for PBS-listed retinoids and contraceptives. We also estimated concomitant oral retinoid and contraceptive use on the day of each retinoid dispensing and determined if there was a period of contraceptive treatment that overlapped. Estimates were then extrapolated to the national level. RESULTS There were 1,545,800 retinoid dispensings to reproductive-aged women; 57.1% were oral retinoids. The rate of retinoid dispensing to reproductive-aged women increased annually, from 28 dispensings per 1000 population in 2013 to 41 per 1000 in 2021. The rate of oral retinoid dispensing doubled over the study period, from 14 dispensings per 1000 population in 2013 to 28 per 1000 in 2021, while topical retinoid dispensing did not change. Only 25% of oral retinoid dispensings had evidence of concomitant contraceptive use in 2021. CONCLUSIONS Rates of oral retinoid dispensing have doubled among reproductive-aged women over the past decade. A large percentage of oral retinoid use does not appear to have concomitant contraception use, posing a risk of teratogenic effects in pregnancies.
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Affiliation(s)
- Laura Gerhardy
- Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Natasha Nassar
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School and Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, New South Wales, Australia
| | - Melisa Litchfield
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Debra Kennedy
- Royal Hospital for Women, Randwick, New South Wales, Australia
| | - Annika Smith
- University of New South Wales, Darlinghurst, New South Wales, Australia
- Australia and St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Malcolm B Gillies
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Sallie-Anne Pearson
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia
| | - Helga Zoega
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Kensington, New South Wales, Australia
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Antonia Shand
- Royal Hospital for Women, Randwick, New South Wales, Australia
- Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School and Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, New South Wales, Australia
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Ivask M, Kurvits K, Uusküla M, Juppo A, Laius O, Siven M. Compliance with Pregnancy Prevention Recommendations for Isotretinoin Following the Amendment of the European Union Pregnancy Prevention Program: A Repeat Study in Estonia. Drugs Real World Outcomes 2024; 11:91-98. [PMID: 37462893 DOI: 10.1007/s40801-023-00381-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/27/2023] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Isotretinoin, indicated for severe acne, is a potent teratogen and therefore contraindicated in pregnancy. Thus, the pregnancy prevention program (PPP) for isotretinoin has been introduced. OBJECTIVES The aim of this study was to assess the concomitant use of isotretinoin and effective contraception and the rate of potential isotretinoin-exposed pregnancies in females of childbearing age in 2017-2020 in Estonia. In addition, we aimed to evaluate whether compliance with the PPP has improved compared with the previous study conducted in Estonia covering the period of 2012-2016. METHODS This retrospective, nationwide study using prescription and healthcare claims data included 2575 females aged 15-45 years who started using isotretinoin between 2017 and 2020. RESULTS For 64.7% of females of childbearing age, no concurrent use of an effective contraceptive was detected while using isotretinoin. A moderately higher contraceptive coverage (35.3%) was observed compared with the previous study (29.7%) (p < 0.001). Complete contraception coverage was highest in females aged 30-39 years with an adjusted OR of 12.8 (p < 0.001) compared with the age group 15-19 years and 2.47 (p < 0.001) compared with the age group 20-29 years. 17 pregnancies coincided with the isotretinoin treatment-related period. The risk for potential isotretinoin-exposed pregnancy was 6.6 (95% CI 3.9-10.5) per 1000 treated females of childbearing age over the 4-year observation period. The risk for potential isotretinoin-exposed pregnancies per 1000 treated females was 1.0 in females aged 15-19 years, 11.6 in females aged 20-29 years, 8.8 in females aged 30-39 years, and 7.4 in females aged 40-45 years (p = 0.009). CONCLUSION A slight improvement in complete contraceptive coverage during isotretinoin use has not resulted in a decrease in the risk of isotretinoin-exposed pregnancies. The contraceptive usage and risk for pregnancy vary greatly across age groups, suggesting the need for a more targeted approach to improve the effectiveness of the PPP.
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Affiliation(s)
- Maaja Ivask
- Faculty of Pharmacy, University of Helsinki, Helsinki, Finland.
- Roche International Pharmacovigilance, Roche Eesti OÜ, Tallinn, Estonia.
| | | | | | - Anne Juppo
- Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
| | - Ott Laius
- State Agency of Medicines, Tartu, Estonia
| | - Mia Siven
- Faculty of Pharmacy, University of Helsinki, Helsinki, Finland
- Helsinki Institute of Sustainability Science, HELSUS, Helsinki, Finland
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Hughes JE, Buckley N, Looney Y, Kirwan G, Mullooly M, Bennett KE. Evaluating awareness, knowledge and practice of healthcare professionals following implementation of a revised pregnancy prevention programme for isotretinoin in Ireland: A multi-stakeholder cross-sectional study. Pharmacoepidemiol Drug Saf 2023; 32:137-147. [PMID: 36073295 PMCID: PMC10092126 DOI: 10.1002/pds.5538] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 08/10/2022] [Accepted: 09/05/2022] [Indexed: 01/26/2023]
Abstract
PURPOSE In 2018, following an EU-wide safety review, a revised pregnancy prevention programme (PPP) was introduced for isotretinoin (Roaccutane®). This study aimed to examine awareness, knowledge, and experience implementing the revised isotretinoin PPP in clinical practice across three healthcare professional (HCP) groups in Ireland. METHODS A cross-sectional study using anonymous online surveys among general practitioners (GPs), community pharmacists, and specialist consultants was undertaken. Descriptive analyses are presented. RESULTS Across all HCP groups there was high (≥87%) awareness that oral isotretinoin is contraindicated in women of childbearing potential (WCBP) unless the conditions of the PPP are fulfilled, but varying awareness among GPs (54.9%) and community pharmacists (45.9%) that exposure during pregnancy can cause both severe fetal malformations and spontaneous abortions. Implementation of the PPP in clinical practice varied across HCP groups. When initiating isotretinoin in WCBP, 66.7% of specialists and 40.8% of GPs indicated they had considered alternative treatment options, and 71.4% of specialists and 31.6% of GPs reported they first requested a pregnancy test. There was limited provision of the patient reminder card to WCBP, where 26.1% of community pharmacists provide this at each dispensing, while 47.6% of specialists and 11.8% of GPs ensured WCBP had a copy of the card when initiating treatment. Across all HCP groups, there was high (≥81.6%) awareness of the need for urgent consultation and immediate cessation of isotretinoin in the event of an unplanned or suspected pregnancy. CONCLUSIONS Reinforcement of the provision and utilisation of the isotretinoin patient reminder card may be required, and further targeted education on specific elements of the PPP should be considered for GPs and community pharmacists.
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Affiliation(s)
- John E Hughes
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Niamh Buckley
- Health Products Regulatory Authority, Kevin O'Malley House, Earlsfort Terrace, Dublin 2, Ireland
| | - Yvonne Looney
- Health Products Regulatory Authority, Kevin O'Malley House, Earlsfort Terrace, Dublin 2, Ireland
| | - Gráinne Kirwan
- Health Products Regulatory Authority, Kevin O'Malley House, Earlsfort Terrace, Dublin 2, Ireland
| | - Maeve Mullooly
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
| | - Kathleen E Bennett
- School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland.,Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland
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Jarab AS, Al-Azzam S, Almutairi S, Mukattash TL. Patients' Knowledge and Information Needs about Isotretinoin Therapy Use in Jordan. Int J Clin Pract 2022; 2022:9443884. [PMID: 35685597 PMCID: PMC9159128 DOI: 10.1155/2022/9443884] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/19/2022] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Despite being the first-line treatment for severe or moderate acne, isotretinoin has several serious side effects that necessitate the evaluation of patients' knowledge about isotretinoin side effects and its proper use. OBJECTIVE The current study aim was to explore information needs about isotretinoin by evaluating patients' knowledge about the appropriate use of isotretinoin and its associated side effects. METHODS In addition to the sociodemographic variables, a validated online questionnaire was adopted from the literature to evaluate patients' knowledge about isotretinoin use and its potential side effects. Independent t-test and one-way analysis of variance (ANOVA) test were implemented to find the correlation between the study variables and the knowledge score. RESULTS The most recognized side effect of isotretinoin therapy was dryness (98.1%). The study patients showed good knowledge about isotretinoin use with a mean knowledge score of 8.1 (SD = 0.7). However, more than half of them (61.0%) mistakenly thought that isotretinoin therapy should be taken continuously for more than 6 months without stop, and some of them did not know that isotretinoin is recommended to be taken with fatty meal (24%) and sunblock (24.6%). Female gender (8.2 (SD = 0.8)) and using isotretinoin for more than 6 months (8.3 (SD = 1.2)) were significantly associated with a higher knowledge score of isotretinoin use (p=0.01), when compared with male patients (7.8 (SD = 0.7)) and less than 6-month use of isotretinoin (7.7 (SD = 0.7)). CONCLUSIONS The lack of patients' information about the potential side effects, duration of therapy, and some instructions on isotretinoin use, such as taking the medication with fatty meal and sunblock, shed the light on the necessity to prepare leaflets, educational brochures, and educational posts via social media in order to improve patients' knowledge about isotretinoin therapy and its optimal use.
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Affiliation(s)
- Anan S. Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Sayer Al-Azzam
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Shriefa Almutairi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
| | - Tareq L. Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, P.O. Box 3030, Irbid 22110, Jordan
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Ibrahim AAM, Alshatri AA, Alsuwaidan S, Almutairi L, Aljasser N, Mahmoud MA, Alaseeri A, Almonysir A, Alotaibi B, Alrasheed B, Alfawaz M. Awareness of isotretinoin use and Saudi FDA pregnancy prevention program in Riyadh, Saudi Arabia: A cross-sectional study among female patients. Saudi Pharm J 2021; 29:527-532. [PMID: 34194259 PMCID: PMC8233528 DOI: 10.1016/j.jsps.2021.04.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 04/13/2021] [Indexed: 11/18/2022] Open
Abstract
Introduction Oral isotretinoin is an effective agent for the treatment of severe cystic acne. Isotretinoin is a teratogen; there is an increased risk of congenital defects in infants exposed to the drug in the uterus. The Saudi Food and Drug Authority (SFDA) has implemented a pregnancy prevention program (PPP) to protect females from those teratogenic effects. Objectives To investigate the awareness of women, of reproductive age who were using Isotretinoin or used it previously, about isotretinoin use and the SFDA-approved PPP in Riyadh, Saudi Arabia. Methods This cross-sectional study was conducted during the period from June to October 2019. A questionnaire was developed based on the published literature and the PPP recommendations. The study was carried out online among female patients who were on Isotretinoin therapy or have used it previously in Riyadh city. The Statistical Package for Social Sciences (SPSS for Windows, version 24) was used to analyze the study data. Results During the study period, 483 patients participated in the study. Among them, 97.3% reported that they used the drug based on a doctor’s prescription, 94.6% were aware of Isotretinoin’s teratogenic effect, and 30.6% confirmed their awareness of the PPP. Amongst the participants, 9.1% (n = 44) used Isotretinoin while being married or planning to get married within a one-month period after using it. Concerning the use of two contraceptive methods according to the PPP guidelines, of the participants, 43.2% reported that they have been informed by their healthcare providers to use two contraceptive methods before starting the medication. Also 43.2% reported that they have been informed to use two contraceptive methods while using the medication, and 50% reported that they have been informed to use two contraceptive methods for one month after stopping the medication. Regardless of the information they had, participants’ actual practice, was as follow: 15.9% used two contraceptive methods before starting the medication, 15.9% used two contraceptive methods during the treatment, and 13.6% used two contraceptive methods for one month after stopping the medication. Conclusions Although this study revealed that the vast majority of participants were aware of isotretinoin’s teratogenic effect, still a considerable number of them had no idea about the PPP. This issue needs to greatly be addressed to minimize the risk of teratogenicity.
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Affiliation(s)
- Alnada Abdalla Mohamed Ibrahim
- Department of Pharmacy Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
- Corresponding author.
| | - Amal Almotiry Alshatri
- Drug Safety and Risk Management Department, Saudi Food and Drug Authority (SFDA), Riyadh, Saudi Arabia
| | - Salem Alsuwaidan
- Kind Saud Medical City, Research and Innovation Center, Riyadh, Saudi Arabia
| | - Lulu Almutairi
- Research Center & Consulting Studies, Saudi Food and Drug Authority (SFDA), Riyadh, Saudi Arabia
| | - Nasser Aljasser
- Drug Safety and Risk Management Department, Saudi Food and Drug Authority (SFDA), Riyadh, Saudi Arabia
| | - Mansour Adam Mahmoud
- Department of Clinical and Hospital Pharmacy, College of Pharmacy, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Afnan Alaseeri
- College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Abrar Almonysir
- College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Badraa Alotaibi
- College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Batoul Alrasheed
- College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Maram Alfawaz
- College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Awareness on Teratogenic Effects of Isotretinoin and Compliance with Precautionary Measures among Women of Childbearing Age in Makkah Province, Saudi Arabia. Obstet Gynecol Int 2021; 2021:9966300. [PMID: 33936210 PMCID: PMC8055435 DOI: 10.1155/2021/9966300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 03/30/2021] [Indexed: 11/18/2022] Open
Abstract
Acne vulgaris ranks among the most common dermatologic conditions encountered during adolescence up to adulthood. For moderate to severe cases of acne, isotretinoin is indicated as it is considered the most efficacious medication against acne. However, isotretinoin use is known to have its side effects and most importantly is the drug's teratogenic potential. As a response, programs such as the Retinoid Pregnancy Prevention Program (PPP), System to Manage Accutane-Related Teratogenicity (SMART), and iPLEDGE were put into action as attempts to promote awareness on isotretinoin's teratogenicity and reduce the incidence of exposed pregnancies. Such programs are lacking in Saudi Arabia. This study aimed, therefore, to evaluate the awareness of women of childbearing age in Makkah Province, Saudi Arabia, with regards to the side effects of the medication, specifically its teratogenicity. This study also intended to assess the compliance of both doctors and patients with the recommendations and precautions associated with isotretinoin. A cross-sectional study was conducted on 766 women participants using a previously validated questionnaire. Results showed that majority of the respondents (91%) are generally aware of the side effects of isotretinoin use, particularly its teratogenicity. However, lapses have been identified with regards to the compliance of both the treating physician and the patient. Three-fourths of sexually active women did not use any form of contraception while being on isotretinoin treatment. Two-thirds of the study participants responded that they were not issued approval forms indicating their understanding of the side effects of isotretinoin and the importance of compliance to the treating physician's instructions; 11.5% claimed that their doctors did not perform any blood tests; and 67.7% claimed that no pregnancy test was performed at any time during the treatment. These findings strongly suggest a need for improvement when it comes to compliance of both doctors and patients. It is recommended that doctor-patient communication be more comprehensive and more efforts should be made to follow international guidelines in that regard.
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Albogami Y, Sarayani A, Hincapie-Castillo JM, Winterstein AG. Real-World Fetal Exposure to Acne Treatments in the United States: A Retrospective Analysis from 2006 to 2015. Drug Saf 2021; 44:447-454. [PMID: 33683646 PMCID: PMC7994218 DOI: 10.1007/s40264-021-01053-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Several studies have evaluated the effects of changes in isotretinoin risk mitigation programs, but little is known about actual fetal exposure rates in the context of other acne treatments. OBJECTIVE Our objective was to quantify fetal exposure rates during the use of common acne treatments. METHODS Employing the insurance claims data of > 100,000 acne treatment users between 2006 and 2015, we created three user cohorts: (1) isotretinoin (strong teratogen/mandatory risk mitigation program), (2) doxycycline/minocycline (mild teratogen, label warning), and (3) topical clindamycin/erythromycin (no fetal risk). Fetal exposure rates overall and stratified by age were compared after adjusting for potential confounders. RESULTS Contraceptive use during acne treatment was < 50% in isotretinoin users and < 30% in the other study groups. Long-acting contraceptives contributed to 1% of all contraceptives used, with 90% being oral contraceptives. Isotretinoin users had 19.2 (95% confidence interval [CI] 20.3 to 17.9) fewer fetal exposures per 1000 person-years of use compared with doxycycline/minocycline users, which in turn had 28.8 (95% CI 31.2 to 26.3) fewer pregnancies compared with clindamycin/erythromycin users. Stratification by age showed attenuated differences in fetal exposure among acne treatment groups for teenagers. CONCLUSION Fetal exposure to acne treatments varied according to levels of teratogenicity, with reduced rates among users of isotretinoin and to a lesser extent doxycycline/minocycline. Teenagers had low pregnancy rates but less pronounced differences in fetal exposure across acne treatments.
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Affiliation(s)
- Yasser Albogami
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
- Center for Drug Evaluation and Safety, University of Florida College of Pharmacy, 1225 Center Drive, HPNP Building, Rm 3334, PO Box 100496, Gainesville, FL, 32610, USA
| | - Amir Sarayani
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Center for Drug Evaluation and Safety, University of Florida College of Pharmacy, 1225 Center Drive, HPNP Building, Rm 3334, PO Box 100496, Gainesville, FL, 32610, USA
| | - Juan M Hincapie-Castillo
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Center for Drug Evaluation and Safety, University of Florida College of Pharmacy, 1225 Center Drive, HPNP Building, Rm 3334, PO Box 100496, Gainesville, FL, 32610, USA
| | - Almut G Winterstein
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, FL, USA.
- Center for Drug Evaluation and Safety, University of Florida College of Pharmacy, 1225 Center Drive, HPNP Building, Rm 3334, PO Box 100496, Gainesville, FL, 32610, USA.
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Non-compliance with pregnancy prevention recommendations for isotretinoin in Korea between 2019-2020. Obstet Gynecol Sci 2021; 64:201-208. [PMID: 33752279 PMCID: PMC7990996 DOI: 10.5468/ogs.20247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 11/08/2020] [Indexed: 11/29/2022] Open
Abstract
Objective Isotretinoin is commonly prescribed worldwide despite its notorious teratogenicity. A risk management program (RMP) was introduced in Korea to prevent isotretinoin use during pregnancy. Here, we evaluate the compliance of Korean women with the recommendations of the RMP. Methods This prospective cohort study was conducted between April 2019 and June 2020. Thirty-six and 82 patients received the prescription before and after the introduction of RMP, respectively. Results There was a significant difference in the total number of days for which isotretinoin was prescribed before and after the RMP was introduced (68.8±100.9 and 28.0±26.1 days, respectively). However, 1.43% (120/8,394) of the total patients contacted by the teratology information services were exposed to isotretinoin on an average. Conclusion The proportion of patients exposed to isotretinoin did not change, and there was no significant change in compliance, with the implementation of the RMP during the study period. Further studies are needed to evaluate the effectiveness of the RMP in the long term.
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Shroukh WA, Steinke DT, Willis SC. Risk management of teratogenic medicines: A systematic review. Birth Defects Res 2020; 112:1755-1786. [DOI: 10.1002/bdr2.1799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Wejdan A. Shroukh
- Division of Pharmacy and Optometry, School of Health Sciences The University of Manchester Manchester UK
| | - Douglas T. Steinke
- Division of Pharmacy and Optometry, School of Health Sciences The University of Manchester Manchester UK
| | - Sarah C. Willis
- Division of Pharmacy and Optometry, School of Health Sciences The University of Manchester Manchester UK
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Macklis P, Vandersall A, Benedict J, Tyler K, Kaffenberger J. Factors influencing patients' choice of contraceptives when starting isotretinoin. J Am Acad Dermatol 2019; 85:737-738. [PMID: 31351892 DOI: 10.1016/j.jaad.2019.07.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/18/2019] [Accepted: 07/19/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Paul Macklis
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Abbey Vandersall
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jason Benedict
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Kelly Tyler
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Jessica Kaffenberger
- Division of Dermatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio.
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