A long-term cohort study of acitretin for prevention of keratinocyte carcinoma in solid organ transplant recipients.
acitretin
chemoprevention
immunosuppression
organ transplants
retinoids
skin neoplasms
squamous cell carcinoma
Journal
The Australasian journal of dermatology
ISSN: 1440-0960
Titre abrégé: Australas J Dermatol
Pays: Australia
ID NLM: 0135232
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
revised:
25
02
2022
received:
02
01
2022
accepted:
05
03
2022
pubmed:
26
3
2022
medline:
20
5
2022
entrez:
25
3
2022
Statut:
ppublish
Résumé
Solid organ transplant recipients (SOTR) are at high risk of keratinocyte carcinoma (KC). Long-term evidence for acitretin as chemoprophylaxis in this population is lacking. To determine the benefit of long-term acitretin for KC chemoprevention in SOTR. A retrospective cohort study of SOTR treated with acitretin at an Australian transplant dermatology clinic was performed. General estimating equations were used to evaluate change in rates of histologically confirmed KC in the 6-12 months prior to acitretin and following a minimum 6 months of treatment. A control group of patients within the same service was included, comprising SOTR who were not treated with acitretin. Twenty-two patients received acitretin treatment for at least 6 months, eighteen for at least 5 years and four for at least 9 years. The median KC rate pretreatment was 3.31 per year (IQR 1.93, 5.40). There was a significant reduction in the rate of KC in the first year of acitretin treatment (IRR 0.41, 95% CI 0.22, 0.76, P = 0.005), and this effect was observed for 5 years (IRR at 5 years 0.34, 95% CI 0.17, 0.67, P = 0.002). The control group had no statistically significant change in KC rate over time in the study. Acitretin appears to be well-tolerated and effective in reducing KC in SOTR for at least 5 years. Study limitations include its retrospective nature, small sample size and lack of blinding.
Sections du résumé
BACKGROUND
BACKGROUND
Solid organ transplant recipients (SOTR) are at high risk of keratinocyte carcinoma (KC). Long-term evidence for acitretin as chemoprophylaxis in this population is lacking.
OBJECTIVE
OBJECTIVE
To determine the benefit of long-term acitretin for KC chemoprevention in SOTR.
METHODS
METHODS
A retrospective cohort study of SOTR treated with acitretin at an Australian transplant dermatology clinic was performed. General estimating equations were used to evaluate change in rates of histologically confirmed KC in the 6-12 months prior to acitretin and following a minimum 6 months of treatment. A control group of patients within the same service was included, comprising SOTR who were not treated with acitretin.
RESULTS
RESULTS
Twenty-two patients received acitretin treatment for at least 6 months, eighteen for at least 5 years and four for at least 9 years. The median KC rate pretreatment was 3.31 per year (IQR 1.93, 5.40). There was a significant reduction in the rate of KC in the first year of acitretin treatment (IRR 0.41, 95% CI 0.22, 0.76, P = 0.005), and this effect was observed for 5 years (IRR at 5 years 0.34, 95% CI 0.17, 0.67, P = 0.002). The control group had no statistically significant change in KC rate over time in the study.
CONCLUSIONS
CONCLUSIONS
Acitretin appears to be well-tolerated and effective in reducing KC in SOTR for at least 5 years. Study limitations include its retrospective nature, small sample size and lack of blinding.
Identifiants
pubmed: 35333399
doi: 10.1111/ajd.13821
pmc: PMC9311671
doi:
Substances chimiques
Acitretin
LCH760E9T7
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e121-e126Subventions
Organisme : Skin Health Institute, Carlton, Victoria, Australia
Informations de copyright
© 2022 The Authors. Australasian Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Australasian College of Dermatologists.
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