Single-institution retrospective review evaluating the impact of the Covid-19 pandemic on isotretinoin prescribing practices

Figures & data

Table 1. Study population characteristics describing isotretinoin prescribing practices.

Variable	Total cohort (n = 264)	Started and completed isotretinoin course before 12 March 2020^a (n = 99)	Started isotretinoin course before and completed after 12 March 2020 (n = 82)	Started and completed isotretinoin course after 12 March 2020 (n = 83)	p-value
Sex
Males	104 (39%)	47 (47%)	32 (39%)	25 (30%)	0.026
Females	160 (61%)	52 (53%)	50 (61%)	58 (70%)	0.72
Mean age and range (years)	23.6 (17–30)	22.9 (17–30)	24.0 (17–30)	24.2 (17–30)	0.038
Mean treatment duration (months)	6.07	5.76	6.73	5.77	0.0074
Mean cumulative dosage (mg/kg)	144.53	139.09	147.28	147.69	0.79
Median number of laboratory monitoring visits^b	3.5	3	4	3	0.87
Median number of telehealth visits	1	0	2	2.5	<0.001
Outcome^c
n, required additional oral treatment after isotretinoin (%)	25 (9.5%)	8 (8.1%)	8 (9.8%)	9 (10.8%)	0.96
n, did not require additional oral treatment after isotretinoin (%)	138 (52.3%)	46 (46.5%)	50 (61.0%)	42 (50.6%)	0.71
n, unknown or lost to follow-up (%)	101 (38.3%)	45 (45.5%)	24 (29.3%)	32 (38.6%)	0.036
Type of oral treatment after isotretinoin^d
Spironolactone	13 (46%)	3 (38%)	3 (33%)	7 (64%)	0.29
Antibiotics	5 (18%)	2 (25%)	2 (22%)	1 (9%)	0.82
An additional isotretinoin course	10 (36%)	3 (38%)	4 (44%)	3 (27%)	0.90

^a 12 March 2020 was selected as a proxy for the Covid-19 pandemic start date, coinciding with the declaration of a state of emergency by the New York City government. The year prior and the year following the pandemic start date were compared.

^b Pregnancy tests were excluded from the laboratory monitoring visits as all patients of child-bearing potential received pregnancy tests every month during treatment.

^c Patients were followed for recidivism for 12 months after isotretinoin completion.

^d Patients could have been prescribed more than one type of oral treatment after isotretinoin.