Accutane IBD: The Waters Are Further Muddied

New Orleans, LAA dermatologist attending the recent annual gathering of the American Academy of Dermatology (AAD) in New Orleans mused that he could see the potential for isotetrinoin (Accutane) patients having been prescribed the drug for acne and later encountering Accutane inflammatory bowel disease (IBD) actually suing their dermatologist.

Most lawsuits associated with Accutane IBD name the manufacturer as defendant. However, a recent large study linking the use of tetracycline-class antibiotics to the emergence of IBD was a cause for concern amongst the attendees.

Elsevier Global Medical News reported February 5 on the AGM of the AAD, which showcased a retrospective cohort study of 94,487 acne patients registered in the Health Improvement Network database in the United Kingdom, representing a whopping 406,000 person-years.

Of all the tetracycline-class drugs studied, doxycycline was found to carry the highest risk for IBD, with a 2.25 fold increase in risk for the development of Crohn's disease over acne patients not exposed to antibiotics.

Researchers at the University of Pennsylvania conducted the study. Their findings determined that the 36,603 British acne patients exposed to tetracycline were shown to have a 61 percent increased rate of Crohn's disease relative to those not receiving the antibiotic.

Accutane IBD was also discussed at the conference, since most problematic acne patients are treated with tetracycline-class drugs prior to moving toward a drug like isotretinoin, which is not an antibiotic but a Vitamin A-based drug and considered a therapy of last resort for extreme cases of acne.

Dr. Diane M. Thiboutot noted that a recent large case-control study revealed an associated 4.4-fold increased risk of ulcerative colitis in patients exposed to isotretinoin (Accutane), but no increase in incidence of Crohn's disease. However, the United Kingdom study appeared to show the opposite is true with patients exposed to tetracycline-class drugs such as doxycycline: a relationship between the drug and Crohn's disease, but not ulcerative colitis.

The fact that most problematic acne patients are treated with tetracycline before moving on to isotetrinoin, assuming the antibiotic fails, serves to muddy the waters, attendees were told. To wit, a patient taking the Accutane drug and developing Accutane IBD may have causation confounded by having been previously exposed to tetracycline.

The manufacturer of Accutane, Hoffmann-LaRoche, withdrew Accutane from the market in 2009 due to what it described as market forces. However, isotetrinoin is still available in generic form. Many patients suffering from various Accutane side effects—and especially the debilitating inflammatory bowel disease, have launched lawsuits against the manufacturer of Accutane. This latest news with regard to the potential for trouble with tetracycline, and its potential relationship to Accutane class-action patients, would be of interest to Accutane attorneys.