Therapeutic Journey Among Patients with Acne Treated with Isotretinoin

INTRODUCTION: Although isotretinoin is approved for severe recalcitrant nodular acne, it is broadly used among patients with acne in clinical practice. The objective of this study was to characterize the profile and therapeutic journey of patients with acne treated with isotretinoin. METHODS: Using the MarketScan® Commercial Claims and Encounters Database, we identified patients diagnosed with acne who received isotretinoin before 30 June 2023. Outcomes included: time to isotretinoin discontinuation, antibiotic initiation after isotretinoin discontinuation, isotretinoin restart, and acne treatment reinitiation. Treatment courses prior to isotretinoin initiation were also assessed. RESULTS: A total of 71,340 patients were included. Overall, 28.4% initiated isotretinoin without prior acne treatment, 48.3% had ≥ 1 and 23.3% had ≥ 2. Adolescents were more likely to have multiple prior acne treatments compared with adults, who more frequently started isotretinoin without prior acne therapy (34.0% versus 25.7%). The median time to isotretinoin discontinuation was 5.97 months. At 12 months following isotretinoin discontinuation, 5.4% of patients restarted isotretinoin and 12.1% initiated antibiotic therapy. CONCLUSIONS: Our findings highlight the substantial burden of acne requiring isotretinoin and underscore the need for tailored treatment approaches that account for differences in age, sex, and real-world treatment patterns.