CoChat
Sign Up
Cited by 161Inflammatory Bowel DiseaseAcne and Rosacea Treatments and EffectsPregnancy and Medication Impact

Isotretinoin use and the risk of inflammatory bowel disease: a case-control study

Open access
Crockett, Seth D, Porter, Carol Q, Martin, Christopher F, Sandler, Robert S, Kappelman, Michael D·2010·American Journal of Gastroenterology
DOI 10.1038/ajg.2010.124PMC PMC3073620
Open this paper in CoChat — free account

Abstract

OBJECTIVES: Isotretinoin is commonly prescribed for the treatment of severe acne. Although cases of inflammatory bowel disease (IBD) have been reported in isotretinoin users, a causal association remains unproven. METHODS: We performed a case-control study using a large insurance claims database. Incident cases of IBD were identified and matched to three controls on the basis of age, gender, geographical region, health plan, and length of enrollment. Isotretinoin exposure was assessed in a 12-month period before case ascertainment. Conditional logistic regression was used to adjust for matching variables. RESULTS: The study population comprised 8,189 cases (3,664 Crohn's disease (CD), 4,428 ulcerative colitis (UC), and 97 IBD unspecified) and 21,832 controls. A total of 60 subjects (24 cases and 36 controls) were exposed to isotretinoin. UC was strongly associated with previous isotretinoin exposure (odds ratio (OR) 4.36, 95% confidence interval (CI): 1.97, 9.66). However, there was no apparent association between isotretinoin and CD (OR 0.68, 95% CI: 0.28, 1.68). Increasing dose of isotretinoin was associated with elevated risk of UC (OR per 20 mg increase in dose: 1.50, 95% CI: 1.08, 2.09). Compared with non-users, the risk of UC was highest in those exposed to isotretinoin for more than 2 months (OR 5.63, 95% CI: 2.10, 15.03). CONCLUSIONS: UC but not CD is associated with previous isotretinoin exposure. Higher dose of isotretinoin seems to augment this risk. Although the absolute risk of developing UC after taking isotretinoin is likely quite small, clinicians prescribing isotretinoin as well as prospective patients should be aware of this possible association.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1038/ajg.2010.124

Cites

42 of 42 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Low-certainty evidence from seven observational studies with substantial heterogeneity does not support a significant association between isotretinoin use and inflammatory bowel disease incidence, including ulcerative colitis and Crohn's disease.

    “Available low certainty evidence from 7 observational studies with substantial heterogeneity do not support a significant association between isotretinoin use and IBD incidence, including ulcerative colitis and Crohn's disease.”

    From Guidelines of care for the management of acne vulgaris (2024) · cites this paper as [281]

    Split into 2 atoms — 0 confirmed, 0 partially supported, 2 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

  • The overall relative risk of inflammatory bowel disease between isotretinoin-exposed and unexposed groups is estimated at 1.13 (95% CI 0.89-1.43).

    “The overall RR of IBD between isotretinoin-exposed and unexposed groups is estimated at 1.13 (95% confidence interval, 0.89, 1.43).”

    From Guidelines of care for the management of acne vulgaris (2024) · cites this paper as [281]

    The Results, under “Results of matched analyses” (page not provided), report an overall IBD odds ratio of 1.68 (95% CI 0.98–2.86) for any isotretinoin use, not the claimed relative risk of 1.13 (95% CI 0.89–1.43). The Methods, under “Statistical analysis,” specify that the study estimated odds ratios rather than relative risks. (LLM, conf=0.90)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. [17]Crockett S Gulati A Sandler RS Kappelman MD A causal association between Accutane and IBD has yet to be established Am J Gastroenterol 2009 (In press)
  2. [33]Greenland SLT Rothman KGS Lash TL Bias Analysis Modern Epidemiology 3 Philadelphia, PA Lippincott Williams & Wilkins 2008 358 359

Cited by

Sorted by citations

Related

Authors
Crockett, S. D., Porter, C. Q., Martin, C. F., Sandler, R. S., & Kappelman, M. D.
Affiliations
University of North Carolina at Chapel Hill (US)
Corresponding author
Crockett, Seth D
ORCID
Venue
American Journal of Gastroenterology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2010-09
Volume
105
Issue
9
Pages
1986-1993
ISSN
0002-9270 (ISSN-L)
DOI
10.1038/ajg.2010.124
PMC
PMC3073620
OpenAlex
W2097683008
Semantic Scholar
2b88116b2779af270a004e9ddf793b5baf3ff65e
Cited by
161
References
42
Citations by year
2026: 4 · 2025: 7 · 2024: 7 · 2023: 5 · 2022: 5 · 2021: 3 · 2020: 16 · 2019: 9 · 2018: 9 · 2017: 6 · 2016: 14 · 2015: 13 · 2014: 9 · 2013: 31 · 2012: 10
FWCI
9.62
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (unspecified)
Locations
  • The American Journal of Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007634, P30DK034987)
  • National Institute of Environmental Health Sciences (P30ES010126)
  • National Center for Research Resources (KL2RR025746)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
  • Health Sciences › Medicine › Dermatology › Acne and Rosacea Treatments and Effects
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
Keywords
isotretinoin, inflammatory bowel disease, ulcerative colitis, Crohn's disease, drug safety, adverse drug reactions, acne treatment, dose-response relationship, drug exposure duration
MeSH terms
Acne Vulgaris, Adolescent, Adult, Child, Dermatologic Agents, Dose-Response Relationship, Drug, Female, Humans, Male, Middle Aged, Risk, Inflammatory Bowel Diseases, Isotretinoin, Logistic Models, Odds Ratio, Case-Control Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review