Zaib, Farwa Naqvi, Sumara Rashid, Sara Inayat, Anam Ilyas, Ahmad Amin Khan Faraz.
To assess the efficacy of isotretinoin in acne vulgaris with daily versus pulse therapy.
J Pak Assoc Derma Jan ;30(2):271-6.

Aim: To determine the Efficacy of isotretinoin in acne vulgaris daily versus pulse therapy.   Study design: A randomized controlled trial.   Place and duration of study: Outpatient Department of Dermatology, Sargodha Medical College, Sargodha, from June 2017 to July 2018.   Methods: There were total 150 patients (both male and female) having 75 patients in each group. Group A was given oral isotretinoin capsule 20 mg twice daily for one week after 3 weeks as intermittent/ pulse therapy for 6 months. Group B was given oral isotretinoin capsule 20 mg/daily continuously for 6 months. Group A and B further sub divided into mild, moderate and severe, having 25 patients in each subgroup. The patients were advised to revisit after every 4 weeks for follow-up. Both groups were also advised to apply 1 % clindamycin gel twice a day for 6 months on lesions. The drug is considered efficacious if acne lesion of the patient reduced to 0-5 lesion only.   Results:  In group A, the oral isotretinoin pulse therapy was efficacious in 22 patients (88%) of mild acne, 23 patients (92%) of moderate acne and 19 patients (76%) of severe acne. In group B, the oral isotretinoin continuous therapy was efficacious in 23 patients (92%) of mild acne, 22 patients (88%) of moderate acne and 21 patients (84%) of severe acne. There was no difference in efficacy of drug in mild moderate or severe acne in group A and B as the p – value calculated by One way Anova is 0.091 and 0.098 respectively, which is not significant. It also revealed that there was no statistical difference in efficacy of drug in group A and B , having p value of >0.05.   Conclusion: It is concluded that the efficacy of oral isotretinoin for acne in intermediate/pulse therapy is same. So, we should prefer intermediate/pulse therapy as it is cost effective, there are reduced side effects of drug due to shorter duration and the patient is more compliant.  

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