Long term, low dose Acitretin unlikely to cause liver problems

[Fred]

This study suggests long‐term, low‐dose acitretin in patients with psoriasis is unlikely to cause significant liver or lipid problems.

Quote:

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Background:
This retrospective observational study aimed to investigate the long‐term safety, drug survival, and factors associated with the survival of acitretin in a real‐world setting.

Methods:
Data of adult patients with psoriasis who attended Siriraj Hospital between 2012 and 2017 and were treated with acitretin were reviewed. Demographic data and clinical courses were recorded. The Kaplan–Meier curve and Cox regression were used to calculate drug survival and the factors associated with drug survival, respectively.

Results:
Of 104 patients, 56 and 48 were male and female, respectively, with a mean treatment duration of 3.2 years. The mean cumulative dose per patient was 19.28 ± 7.84 mg/day. Acitretin was administered to 73, 39, 24, and six patients for more than 1, 3, 5, and 10 years, respectively. Most side effects were mild and tolerable; only nine patients withdrew acitretin due to side effects. No patients developed clinical features of cirrhosis or uncontrolled hyperlipidemia. The drug survival rates were 79%, 69.5%, 61.2%, 57.6%, and 53.5% at 1, 2, 3, 4, and 5 years, respectively, higher than those of previous studies. Patients without obesity, metabolic syndrome, and dyslipidemia did not have a significantly longer acitretin survival compared to patients with these comorbidities.

Conclusions:
Long‐term, low‐dose acitretin in patients with psoriasis is unlikely to cause significant liver or lipid problems. In countries with difficulty accessing biological agents for psoriasis, acitretin may have a high drug survival rate due to its long‐term safety. This study has several limitations: its retrospective nature, single‐center study design, and small sample size.

Source: onlinelibrary.wiley.com

*Retrospective observational study no funding declared.

Acitretin

[Wooley]

That's good to hear!!!!

[JohnB]

That is good news, but not what I experienced.

[Fred]

That is good news, but not what I experienced.

Do tell more if you wish.

[Wooley]

To be fair I keep having a high 'liver whatever' count - they had the audacity to say I need to cut down on drinking - I mean come on, give me a break!!!!

Seriously though, whilst I appreciate that this is probably good advice, I don't actually think that it has any relevance to acitretin to be fair.... I have had loads of liver tests and they come back normal - so I am not sure what's going on to be honest.....

[JohnB]

Sorry for the delay Fred.

After a couple of years on Acitretin I had an unusually high liver function reading off one of my blood tests. It effectively tripled from the normal. A second test a few week later showed worse readings and I was immediately taken off Acitretin. Around six weeks after stopping the blood results returned to near normal. So has it done any damage? I doubt I'll ever find out. Can you have long term liver damage with 'normal' blood results?

As for the hyperlipidemia, my cholesterol levels went up almost to the point of them thinking of hitting the Statins, so yes it would be controlled, but is it ideal.

It all goes to prove though that regular frequent testing is a must.

To be honest if it wasn't for the elevated liver I don't think I could have hacked the sides effects much longer

[Fred]

Sorry for the delay Fred.

After a couple of years on Acitretin I had an unusually high liver function reading off one of my blood tests. It effectively tripled from the normal. A second test a few week later showed worse readings and I was immediately taken off Acitretin. Around six weeks after stopping the blood results returned to near normal. So has it done any damage? I doubt I'll ever find out. Can you have long term liver damage with 'normal' blood results?

As for the hyperlipidemia, my cholesterol levels went up almost to the point of them thinking of hitting the Statins, so yes it would be controlled, but is it ideal.

It all goes to prove though that regular frequent testing is a must.

To be honest if it wasn't for the elevated liver I don't think I could have hacked the sides effects much longer

Thank you John.

[Will20]

I took Acitretin for nearly 6 years and my Liver Function Blood Tests increased slowly and I was never told. 
Then taking Methotrexate for 18 months made my Liver Blood Tests go up too.

[jiml]

I took Acitretin for nearly 6 years and my Liver Function Blood Tests increased slowly and I was never told. 
Then taking Methotrexate for 18 months made my Liver Blood Tests go up too.

That's not good they should keep you informed Will I have my bloods done every month and if there's a problem I know the next day and can adjust the size of my fumaderm ... But in over 6 years I've only had problems twice and reducing the dose got my bloods right again...the other thing I do is ask for a copy of the results and in the past I have posted them here in my journal so I can keep an eye on trends

Hope you are ok this time on acetretin