WEDNESDAY, Jan. 15, 2025 -- For patients with acne, a higher cumulative dose of isotretinoin may reduce the risk for relapse and isotretinoin retrial, according to a study published online Jan. 15 in JAMA Dermatology.

Jenny Lai, Ph.D., and John S. Barbieri, M.D., from Harvard Medical School in Boston, conducted a cohort study to examine rates of acne relapse and isotretinoin retrial. A total of 19,907 patients with acne who were aged 12 years or older and had received isotretinoin for four months or longer, with at least one year of continuous enrollment after isotretinoin completion, were included in the study.

The researchers found that 22.5 percent of the participants had acne relapse and 8.2 percent had isotretinoin retrial. Increased rates of acne relapse were seen in association with female sex (hazard ratio, 1.43), while the rate of relapse was reduced in association with isotretinoin cumulative dosage (mg/kg; hazard ratio, 0.996). Among those with conventional and high cumulative dosages, daily dose was not associated with a decreased risk for acne relapse or isotretinoin retrial. Reduced rates of isotretinoin retrial were seen in association with female sex and isotretinoin cumulative dosage (hazard ratios, 0.68 and 0.99, respectively). On stratification by cumulative dosage, patients with low (<120 mg/kg) and conventional (120 to 220 mg/kg) but not high (>220 mg/kg) cumulative dosage had decreased rates of retrial in association with higher cumulative dosage.

"This large cohort study identified factors associated with acne relapse and isotretinoin retrial that may guide treatment selection and prognosis," the authors write.

One author disclosed ties to Dexcel Pharma and Honeydew Care.