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cloudy

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  1. Sigh. Where did I "refute" the previous dosing guidelines? This is ALL I've said:
  2. As fun as slugfests are, nah. I've wasted enough of my time. You insist on misunderstanding, be my guest.
  3. Susan, That was tongue in cheek. I guess I should have used an emoticon. Anyway--I did not pull that tongue-in-cheek definition out of my hat: I have seen that difference in the US/European treatment philosophy mentioned in several places-- I think the latest was in the transcript of some derm symposium speeches. Beenthere, I agree: Jesus. I don't know what you are trying to prove, but I kindly suggest you read the links/this discussion/do your own research when you have sufficient time
  4. OK, excluded from the list despite acknowledging that it is accepted as the most effective treatment, due to the aforementioned complications. Which doesn't tell us anything relevant to this discussion. Well no, i think they'd stick the dosing info in the info pamphlet... Nothing is beyond a reasonable doubt with isotretinoin due to it's unique side effect/dosing relationship. It's dosing is more art than science, as doctors must adjust dosage to each patient individually. But i think i
  5. Look, you really need to read more carefully: isotretinoin is not on the list of drugs that have Level A evidence from controlled studies. It was NOT exluded from the entire analysis. It is on the list of drugs with level B and C evidence. That's all I'm saying. And that several studies --including one adequately powered study by Roche itself-- have lead SOME scientists (including some at the FDA) to question the current dosing guidelines. You choose not to accept the conclusion of the FDA g
  6. Ummmm... they did not exclude isotretinoin. They actually included several trials that compared different dosages of isotretinoin. I quoted that part above. I don't think you got the difficulty right. As to excluding non-English-language reports -- I think that's probably a red herring. Most internationally significant studies eventually get published in peer-reviewed English-language papers. And I'm saying this a as a European who reads several foreign languages, including German. If the
  7. Ummmm... they limited the analysis to controlled trials--how do you interpret that as "requiring them not to include isotretinoin"? The surprising result of their analysis was that there ISN'T Level A (good, statistically valid evidence from well-designed trials) about isotretinoin -- and since the reviewers think it works, they offered a couple of possible/weak explanations for the paucity of acceptable studies. Here are the trials they did include in the analysis:
  8. Where did I say the first link indicates dosing guidelines are too high? I included it to show the studies that dispute the ORIGINAL longitudinal studies that found a link between daily/cumulative doses and relapse. I do not think Roche ever made follow-up studies-- the studies that Roche refers to in its package insert are probably the ones by Leyden et al. As to the second link -- where we agree is that there are so many variables that teasing out statistical significances /real meaning i
  9. Here you go: the second link is to FDA executive summary of Roche's application. Pls. note that it does not address relapse rates. That's why I'm including the first link that summarizes some of the relapse rate studies. http://content.karger.com/ProdukteDB/produ...ename=90646.pdf http://www.fda.gov/ohrms/dockets/ac/00/bac.../3639b1d_01.pdf
  10. I know this is going to sound awfully nitpicky but I think that "Greater need for retreatment with the lower dosages" only applies to doses between 0.1-1.0--like the package insert clearly says. There are no studies ( as far as I can find) about the long-term efficacy of doses higher than 1.0 mg per body weight. And I really think that "more is better" is a dangerous concept with regard to drugs where the line between efficacy and toxicity is often razor thin. Moreover, some of the very la
  11. Beentheredonethat, Could you point me to a study that proves that a dose higher than 1 mg per body weight is preferable/leads to fewer relapses? The package insert you quote only talks about studies comparing doses of 0.1, 0.5 and 1.0/per day:
  12. The devil is in the details. The original poster was on put on an 80 mg dose ( 1.6 mg per kilo of body weight-- not 60 mg and 1.2 like you say) right at the beginning. Most doctors now recommend starting with a low dose (MAX 0.5) to see how an individual responds to the drug. Moreover, 2 mg per body weight is not "aggressive" like you say but the maximum the manufacturer recommends/has tested -- and something that the derm I quoted said is "seldom needed." And, like the research/FDA files I
  13. The side effects depend on the dose PER DAY. You are on a pretty high dose for your weight. Your derm is -- how should I put it politely-- rather aggressive in the way he is treating your acne. Sure, you can get to the total of 150 mg per kilo of body weight in a shorter period of time (3 months instead of five) but the maximum dosing PER DAY guidelines are there for a reason. Taking his approach to its logical conclusions--why not take the entire 150 mg at one go--kill the glands and be done
  14. Spring, Your derm is a professional and has the definite advantage of having seen you in real life & knowing your treatment history. Giving and accepting advice over the internet is risky business anyway. Also, I am not a doctor--I just play one online. All that said, if my daughter was getting married on July 1, there's no way in the world I'd let her start Accutane two months before the wedding. Although your derm is doing her utmost, trying to avoid an initial flare with the antibio
  15. How's this--eat a litttle and THEN take the pill-- kinda in the middle? That way it won't hit the stomach lining first but still gets buried under food, the way you want it. And since you have already had a stomach ulcer, please please please mention this to your doc ASAP. The package insert actually says to stop taking accutane and to contact the doc.
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