RESEARCH - Association or lack of association between tetracyclines used for acne vulgaris and lupus erythematosus

[Guest guest]

Br J Dermatol. 2007 Sep;157(3):540-6. Epub 2007 Jun 26.

Association or lack of association between tetracycline class

antibiotics used for acne vulgaris and lupus erythematosus.

Margolis DJ, Hoffstad O, Bilker W.

Department of Biostatistics and Epidemiology and Center for Clinical

Epidemiology and Biostatistics, University of Pennsylvania, 815

Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104, USA.

BACKGROUND: Previous studies have associated tetracyclines and,

perhaps more specifically, minocycline use for the treatment of acne

with onset of drug-induced lupus erythematosus (LE).

OBJECTIVES: To determine the frequency of LE among those with acne who

used antibiotics from the tetracycline class of antibiotics.

METHODS: A retrospective cohort study of individuals aged 15-35 years

with acne within the practices of the general practice physicians in

the U.K. who participate in The Health Information Network (THIN). Our

outcome measure was physician reports of LE. RESULTS: We identified 97

694 subjects with acne who were followed for about 520 000

person-years. They were on average about 22 years old and 57.5% were

female. Minocycline exposure was noted in 24.8% of our subjects,

doxycycline exposure in 15.6%, other tetracyclines in 42.3%, and 17.3%

had not received a tetracycline antibiotic. The overall hazard ratio

for the association of minocycline to LE was 2.64 (95% confidence

interval 1.51-4.66) and when adjusted for age and gender was 3.11

(1.77-5.48). Those affected were often treated for LE. No association

was noted for doxycycline and the other tetracyclines.

CONCLUSIONS: The use of minocycline and not the other tetracyclines is

associated with LE. LE as reported in THIN often required systemic

therapy. Overall, the event is uncommon but the risk and benefit of

minocycline therapy must be carefully considered.

PMID: 17596147

http://www.ncbi.nlm.nih.gov/pubmed/17596147

Not an MD