This article did a good job of presenting the research observation that in individuals who take isotretinoin for the most severe form of acne there was a higher than expected percentage who developed elevations of triglycerides, cholesterol, or liver enzymes. The article was clear that these elevations had been previously observed but the point of the study was that they were more common than expected. The article presented a useful framework to help readers to understand what these elevations mean in terms of disease risk. It would, however, have been helpful to note that isotretinoin is typically reserved for severe acne because of the potential risk for adverse effects such as those presented in this article, and that other treatments have fewer risks and may sufficiently control the acne.
This was a well rounded report on isotretinoin, its benefits in terms of acne treatment and its potential for harms. A solid, five-star story, and in only 568 words.
Article mentioned cost of $10-15/day, and the drug is typically used for a year.
The story explained the benefits of treating disfiguring acne. Although including the clinician claim that patients have said “You’ve saved my life with this drug” is perhaps a bit over the top.
The risks of birth defects from isotretinoin as well as the risks of abnormal lab tests were presented. The story made clear that an abnormal lab test does not necessarily mean disease.
The article referenced a study in the Archives of Dermatology, from which the data in the article were drawn. The article included the number of patients studied as well as the percentage which went on to develop elevated levels of triglycerides, cholesterol, or liver enzymes.
This story did a good job of presenting the abnormal lab results in a framework that explained that the results were simply that and, though they were worth keeping tabs on, were not absolute guarantee of serious disease.
Besides the information in the research article, this story included additional information about cost and some details about the teratogenic effects of isotretinoin and the FDA patient register as a step to help eliminate this source of birth defects. The one clinician quoted was not involved in the study reported on but had previously been a consultant for the drug manufacturer. It might have been better to have a comment from someone without links to the particular drug company making the product reported on. The story mentioned that company representatives did not respond to an e-mail seeking comment.
While this story was not about the treatment of acne per se but rather about possible side effects from a particular treatment, alternative treatments do exist for severe acne and these could have been mentioned. They include oral antibiotics and, in women, some hormonal therapies in addition to the typical topical treatments such as benzoyl peroxide, retinoids and topical antibiotics among others. Accutane is typically reserved for severe acne because of the potential risk for adverse effects such as those presented in this article. Other treatments have fewer risks and may sufficiently control the acne.
From the story, it was clear that isotretinoin is an FDA approved medication for the treatment of severe acne.
The story reported on a population based study that found triglyceride, cholesterol, and liver enzyme elevations occurred more commonly than previously predicted based on data from clinical trials. The article accurately presented this observation.
Does not appear to rely on a press release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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