2004 to 2019 saw increase in isotretinoin use in girls, women

From 2004 to 2019, there was an increase in isotretinoin use among girls and women of childbearing age in Germany, according to a study published online Jan. 25 in PLOS Medicine.

Jonas Reinold, from the Leibniz Institute for Prevention Research and Epidemiology–BIPS in Bremen, Germany, and colleagues determined the age-standardized prevalence of isotretinoin use between 2004 and 2019 among girls and women aged 13 to 49 years using observational data from the German Pharmacoepidemiological Research Database. The number of exposed pregnancies was estimated by assessing whether there was prescription supply overlapping the beginning of pregnancy or a dispensation within the first eight weeks of pregnancy.

The researchers found that from 2004 to 2019, there was an increase in the age-standardized prevalence of isotretinoin use, from 1.20 to 1.96 per 1,000 girls and women, respectively. A total of 178 pregnancies exposed to isotretinoin were identified in the base case analysis, with a doubling of the number per year during the study period. Among exposed pregnancies, at least 45 percent ended in an induced abortion. The number of exposed pregnancies varied from 172 to 375 in sensitivity analyses. Six of the live-born children had major congenital malformations.

"While our study was not designed to quantify risks, it was still striking that 13 live-born children classified as exposed to isotretinoin in early pregnancy in the base case or the sensitivity analyses had congenital malformations, six of them with major malformations," the authors write.

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