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. 2023 Apr;88(4):841-847.
doi: 10.1016/j.jaad.2023.01.014. Epub 2023 Jan 20.

A propensity score matched cohort study identifying an association of acne, but not oral antibiotic or isotretinoin use, with risk of incident inflammatory bowel disease

Matthew T Taylor  1 , David J Margolis  2 , Shawn G Kwatra  3 , John S Barbieri  4
Affiliations

A propensity score matched cohort study identifying an association of acne, but not oral antibiotic or isotretinoin use, with risk of incident inflammatory bowel disease

Matthew T Taylor et al. J Am Acad Dermatol. 2023 Apr.

Abstract

Background: Concerns remain regarding whether oral antibiotic or isotretinoin use for acne is associated with increased risk of inflammatory bowel disease (IBD); little is known about whether acne itself is associated with IBD.

Objective: To determine whether isotretinoin exposure, oral tetracycline-class antibiotic exposure, and/or acne itself are associated with IBD.

Methods: A propensity score matched cohort study was performed using TriNetX between 2001 and 2022 to compare the 1-year incidence of IBD between those without acne compared to those with acne managed without systemic medications, acne managed with oral tetracycline-class antibiotics, and acne managed with isotretinoin.

Results: There was a statistically significant association between acne and risk of incident IBD (odds ratio: 1.42; 95% confidence interval: 1.23-1.65). There was no statistically significant association between oral tetracycline-class antibiotic or isotretinoin exposure and IBD.

Limitations: Use of electronic health data; potential for misclassification bias.

Conclusion: This matched cohort study identifies an association between acne and IBD. These data provide further reassurance regarding the use of isotretinoin in the treatment of acne.

Keywords: Crohn's disease; acne; doxycycline; inflammatory bowel disease; isotretinoin; minocycline; tetracyclines; ulcerative colitis.

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Conflict of interest statement

Conflicts of interest Dr Kwatra is an advisory board member/consultant for Abbvie, Aslan Pharmaceuticals, Arcutis Biotherapeutics, Castle Biosciences, Celldex Therapeutics, Galderma, Genzada Pharmaceuticals, Incyte Corporation, Johnson & Johnson, Leo Pharma, Novartis Pharmaceuticals Corporation, Pfizer, Regeneron Pharmaceuticals, and Sanofi and has served as an investigator for Galderma, Incyte, Pfizer, and Sanofi. Taylor, Margolis, and Barbieri have no conflicts of interest to declare.

References

    1. Zaenglein AL, Pathy AL, Schlosser BJ, et al. Guidelines of care for the management of acne vulgaris. J Am Acad Dermatol. 2016;74(5):945–973.e33. - PubMed
    1. Barbieri JS, James WD, Margolis DJ. Trends in prescribing behavior of systemic agents used in the treatment of acne among dermatologists and nondermatologists: A retrospective analysis, 2004–2013. J Am Acad Dermatol. 2017;77(3):456–463.e4. - PubMed
    1. Barbieri JS, Bhate K, Hartnett KP, Fleming-Dutra KE, Margolis DJ. Trends in Oral Antibiotic Prescription in Dermatology, 2008 to 2016. JAMA Dermatol. 2019;155(3):290–297. - PMC - PubMed
    1. Isotretinoin, Acne, and Crohn’s Disease: A Convergence of Bad Skin, Bad Science, and Bad Litigation Creates the Perfect Storm. Gastroenterol Hepatol. 2013;9(11):752–755. - PMC - PubMed
    1. Lee SY, Jamal MM, Nguyen ET, Bechtold ML, Nguyen DL. Does exposure to isotretinoin increase the risk for the development of inflammatory bowel disease? A meta-analysis. Eur J Gastroenterol Hepatol. 2016;28(2):210–216. - PubMed

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