Does accutane really effect the growth plates? (paper summary)

[Fuldblod]

The following is a comment i was originally going to post under a thread criticizing the use of accutane. The scope quickly expanded so i decided to make it into a thread here instead.

This thread showcases 2 arguments for accutane and i attempt to debunk / nuance the claims.
Enjoy...

"Among 226 patients treated with isotretinoin and 1179 controls, final height did not differ significantly between groups (−0.67 cm; CI: −2.21 to 0.87). However, patients treated with isotretinoin had a lower postmedication initiation height velocity (−0.12 cm/month; CI: −0.21 to −0.04, P = .005) and a greater reduction in post- versus premedication initiation height velocity (−0.31 cm/month; CI: −0.54 to −0.07, P = .011). No significant dosage effects were observed." [1]

Heres the link to the full article: https://pmc.ncbi.nlm.nih.gov/articles/PMC13162136/#:~:text=There were 179,velocity per individual.

The excerpt you're quoting is very misleading. What they're comparing is isotretinoin to oral antibiotic usage.
Not isotretinoin compared to a control.
So, we can't say much.

This is what happens when you skim the conclusion. Read the full article lulz.
View attachment 5518814

misinformation on the accutane part.
this was only recorded when accutane was used offlabel to treat a rare form of cancer, and instead of using the standard doses, they used an extremely high dose usually 3.5mg/kg (150lbs=525mg) over the course of years. for anyone using the standard 0.5-1mg/kg for a few months there is literally zero risk in anything happening of what you just said

https://www.degruyterbrill.com/document/doi/10.1515/jom-2021-0108/html#j_jom-2021-0108_ref_008

That's a very very conservative argument.
The paper i've linked compiles reports of healthy, normal teens who've gotten "premature epiphyseal fusion" due to low "therapeutic" dose isotretinoin for acne.

Between 1985 and 2021, the FDA received 41 reports worldwide of premature epiphyseal closure related to isotretinoin in patients under 18 years of age. Of those 41 reports, 22 reports were for the treatment of acne, (...) Table 1 shows the results of the FDA reports.
View attachment 5518974
But, rather than definitively proving: "muhh accutane fucks up ur plates niguuhhsss!"
The researcher keenly says in the discussion: "However, the cases reported to the FDA lacked pertinent patient information, including relevant medical history and how the diagnosis of premature epiphyseal closure was made. Thus, the level of evidence is low as to whether isotretinoin was associated with these reports."

It is with this information that we can conclude: Nothing and nada dada



However, we are not scientists who have to stick to the objective facts at all times, we can bend the rules a bit and evaluate ourselves, the dangers of isotretinoin.
If you'd ask me? i think the data is there, it's happened too many times to not be causal and could present a greater risk than non-risk to your future height gains.

That's why i'm ceasing all accutane use pronto. 1 month in and it's not a risk i want to continue with, especially in conjunction with my infig stack that's arriving soon.


Here are some more interesting studies i've compiled for easy reading.

Case studies on kids with cancer or alike that caused permanent growth plate fusion / arrest:

• a 10-year-old female suffered irreversible arrest of the femoral and tibial plates after taking isotretinoin at the average dose of 40 mg/day for 9.8 years to treat neuroblastoma
• a 10-year-old male with premature epiphyseal closure of the knees likely related to isotretinoin therapy for neuroblastoma
• partial epiphyseal fusion of the right tibia was associated with isotretinoin therapy at an average dose of 3.5 mg/kg/day for a couple of years in a 10-year-old boy with history of epidermolytic hyperkeratosis
• reversible growth plate abnormalities of the knees in a case of a 9-year-old boy with fibrodysplasia ossificans progressive, who was treated with isotretinoin at a dose of 5 mg/kg/day for 5 months
• Park et al. reported a case of a 10-year-old male with premature epiphyseal closure of the knees likely related to Isotretinoin therapy for neuroblastoma. The patient was diagnosed with metastatic neuroblastoma to the left proximal humerus at the age of 6 years, (...) the boy then began isotretinoin therapy at a dose of 60 mg/day for 1 year (...) an MRI showed focal closure of the left humeral growth plate, which is the area where the metastatic neuroblastoma was located and on which radiation therapy was focused. Park et al. reported that the physeal closure of the left humerus was likely secondary to focused radiation therapy of that area.

"Most cases of growth failure are reported secondary to high-dose isotretinoin use for prolonged periods and are usually seen in the treatment of neuroblastoma."

"In one study, three out of 216 pediatric neuroblastoma patients developed premature epiphyseal closure after isotretinoin exposure with an incidence rate of 1.4%"

2 peculiar case studies of healthy boys getting x-rays for sports related injuries but accidentally discovering growth plate disfigurement/problems:

• This 14-year-old male in Australia had a history of nonresponsive cystic acne and was treated with isotretinoin at a dose of 0.75 mg/kg/day for 6 months. At 12 months posttreatment, the patient was evaluated with an X-ray imaging of the long leg bones after spraining his knee during a rugby match. The imaging revealed closure of the right lateral femoral physis causing right knee valgus. The other growth plates appeared normal.
  Writer goes on to say how different genetics may affect the drugs metabolization and pharmacogenics.
  I believe he's saying that: people react differently to the drug and in this case it resulted in a local fusion of the physis.
• a 16-year-old male in Switzerland who plays soccer and who was on 0.5 mg/kg/day of isotretinoin therapy for acne for at least 6 months. He complained of knee pain that prompted him to receive an MRI and X-rays of both knees. The X-ray findings were normal, but the MRI showed epiphysiodesis and destruction of the growth plate, with irregular epiphyseal cartilage and associated edema, resulting in the diagnosis of retinoid-induced epiphysiodesis.
  Writer clarifies both patients were examined due to an injury, however no large (bone breaking) injury on this boy happened, and the injury seems "spontaneous" rather than caused by direct injury.

Epiphysiodesis: is a pediatric orthopedic surgery that slows or stops the growth of a bone's growth plate
Retinoid-induced epiphysiodesis: is the rare, premature closing of the bone growth plates (epiphyseal plates) caused by vitamin A-derived medications like systemic retinoids (such as isotretinoin or acitretin)