Relationship Between Serum Vitamin D Levels and Musculoskeletal Adverse Effects in Patients Using Isotretinoin

NCT ID: NCT04204304

Last Updated: 2019-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

177 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-03-15

Study Completion Date

2019-10-01

Brief Summary

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Isotretinoin (ISO) has been used in the treatment of patients with severe acne vulgaris (AV) that is resistant to standard therapy with systemic antibiotics and topical agents, over the last few decades. There are various side effects of ISO in the skeletal system.

This study investigate the relationship between ISO-induced musculoskeletal adverse effects and serum 25 hydroxy (OH) vitamin D levels in patients with acne vulgaris.

Detailed Description

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The rheumatic side effects are the most common one which are musculoskeletal pains and arthralgia, seen over of the 16% patients receiving ISO. Mild, transient myalgias and arthralgias are very common and do not require cessation of the drug. The other musculoskeletal side effects of ISO are calcification of tendon and ligaments, hyperostosis of the spine (DISH syndrome), elevated creatine phosphokinase and cramps. There are many case reports related with ISO-induced sacroiliitis in the literature, mostly recent years.

The association between ISO and vitamin D levels has been evaluated with several studies in the literature17,18,19. However, the relationship between ISO-induced musculoskeletal side effects in AV patients and serum vitamin D levels has not been investigated until now. To the best our knowledge, this is the first study to evaluate the relationship between the serum vitamin D levels and the musculoskeletal side effects related with ISO in AV patients.

In this study, 87 patients receiving ISO for AV and had ISO-induced musculoskeletal side effects, were enrolled as adverse effect (AE) group. The control (C) group was consisted of age- and sex-matched 90 consecutive patients using ISO but had no musculoskeletal symptoms.

The participants was assessed in aspect of musculoskeletal symptoms such as arthralgia, low back pain, calsification of tendon and ligaments, polyneuropathy, hyperostoses of the spine (DISH syndrome), myalgia, cramps and sacroiliitis. It was queried that whether myalgia, arthralgia, low back pain or sacroiliitis has occurred after ISO treatment. Serum 25 (OH) vitamin D levels were measured in all participants. According to these results, patients in AE group were divided into three subgroups in aspect of the serum vitamin D levels. Patients with serum 25 (OH) vitamin D level is lower than 10 ng/ml, was recruited as Group I, between 10-20 ng/ml, as Group II, higher than 20 ng/ml as Group III.

Conditions

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Musculoskeletal Disease Other Isotretinoin Adverse Reaction Vitamin D Deficiency

Keywords

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D014807 D02.455.326.271.665.202.495.325 C17.800.030.150

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Isotretinoin-induced adverse effect group

Patients receiving isotretinoin with dose of 0.5-1 mg/kg/day and had musculoskeletal adverse effects

Group Type EXPERIMENTAL

Isotretinoin

Intervention Type DRUG

ISO

Control group

Pateients receiving isotretinoin with dose of 0.5-1 mg/kg/day had no musculoskeletal adverse effects

Group Type ACTIVE_COMPARATOR

Isotretinoin

Intervention Type DRUG

ISO

Interventions

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Isotretinoin

ISO

Intervention Type DRUG

Other Intervention Names

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Isotretinoin capsules

Eligibility Criteria

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Inclusion Criteria

* ISO at a dose of 0.5-1 mg/kg/day for at least 3 months,
* not to use vitamin D and/or calcium supplements for the last three months
* to be older than 18 years.

Exclusion Criteria

* Patients who had renal, gastroenteritis, skeletal, psychiatric, hematological, endocrine disorders related with thyroid and bone metabolism
* Patients receiving drugs such as diuretics, multivitamins, anticonvulsants, glucocorticoids, erythromycin, estrogen compound pills, alcohol, vitamin D and/or calcium preparats in the last three months,
* Malignancy,
* Chronic liver and kidney failure,
* History of psoralen and ultraviolet A (PUVA)
* Women waiting pregnancy.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Ankara Training and Research Hospital

OTHER

Sponsor Role lead

Responsible Party

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Cevriye Mülkoğlu

Director, clinical research

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Cevriye Mülkoğlu

Role: PRINCIPAL_INVESTIGATOR

Ankara Training and Research Hospital

Locations

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Ankara Training and Research Hospital

Ankara, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Other Identifiers

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AnkaraTRH

Identifier Type: -

Identifier Source: org_study_id