Rheumatology · Dermatology · 53 min ago
Persistent Back Pain After Isotretinoin Discontinuation in One-Quarter of Cohort
In a retrospective cohort of 100 adults with new-onset inflammatory back pain during isotretinoin therapy, symptoms persisted beyond three months after stopping treatment in 23 patients. Achilles enthesopathy was more frequent in the persistent-symptom group; most patients experienced improvement during follow-up.
- Symptoms persisted beyond three months in 23% of patients.
- Bilateral sacroiliitis was reported in 72% on MRI.
- Achilles enthesopathy was more frequent with persistent symptoms.
Researchers retrospectively assessed 100 consecutive adults who developed inflammatory back pain meeting ASAS criteria while taking isotretinoin. They compared clinical, laboratory and imaging findings according to whether symptoms continued for more than three months after isotretinoin was discontinued. Median age was 24 years, 80% were women, and back pain began a median of two months after treatment started.
MRI showed bilateral sacroiliitis in 72%, unilateral sacroiliitis in 20%, and normal findings in 8%. HLA-B27 was detected in 3 of 78 tested patients. Symptoms persisted beyond three months in 23 patients. Compared with those whose symptoms did not persist, this group had higher post-discontinuation BASDAI scores (median 5.05 vs. 2.00) and more frequent Achilles enthesopathy (39.1% vs. 14.3%).
The findings suggest that symptoms generally improve after isotretinoin is stopped, but may continue in a substantial minority. Achilles enthesopathy was associated with persistence and may help identify patients warranting closer rheumatological follow-up. The retrospective design describes associations and does not establish which patients will have persistent symptoms or demonstrate that isotretinoin caused the back pain.
In practice
For adults developing inflammatory back pain while taking isotretinoin, this retrospective cohort found that symptoms continued beyond three months after discontinuation in 23 of 100 patients. Achilles enthesopathy was more common in those with persistent symptoms, which may support closer rheumatological follow-up in that subgroup. The study does not establish causation or provide a validated method for predicting persistence, so it does not justify changing treatment or follow-up practices on its own.
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Clinical Rheumatology: Clinical characteristics of persistent ısotretinoin-associated ınflammatory back pain: a retrospective cohort study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.