Abstract | OBJECTIVE: DATA SOURCES: STUDY SELECTION AND DATA EXTRACTION: Articles selected for inclusion were limited to AN related to obesity with no other underlying etiology. Clinical trials and case reports using monotherapy were included. DATA SYNTHESIS:
Metformin, rosiglitazone, octreotide, vitamin D analogs, and retinoic acid have been used in the treatment of IRORAN. In one randomized trial, metformin 500 mg 3 times daily was compared with rosiglitazone 4 mg once daily. Neither treatment demonstrated significant improvements in AN; however, rosiglitazone did significantly decrease serum insulin levels. In a second clinical trial and in several case reports, AN and hyperinsulinemia did show improvement with metformin treatment. After a 6-month period, octreotide improved IRORAN, body weight, and glucose/ insulin response to a meal. The improvements persisted for 6 additional months after discontinuation of octreotide. Vitamin D analogs and retinoids produced inconsistent results in 5 separate case reports. CONCLUSIONS: IRORAN is a growing problem, particularly in children and adolescents, secondary to the increase in the prevalence of obesity. Treatment of IRONAN should focus on reversal of the underlying hyperinsulinemia. Patients with IRORAN may benefit from a trial of metformin for improvement of lesions and underlying hyperinsulinemia.
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Authors | Anthony Romo, Sandra Benavides |
Journal | The Annals of pharmacotherapy
(Ann Pharmacother)
Vol. 42
Issue 7
Pg. 1090-4
(Jul 2008)
ISSN: 1542-6270 [Electronic] United States |
PMID | 18492785
(Publication Type: Journal Article)
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Chemical References |
- Hypoglycemic Agents
- Retinoids
- Thiazolidinediones
- Rosiglitazone
- Vitamin D
- calcipotriene
- Metformin
- Calcitriol
- Octreotide
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Topics |
- Acanthosis Nigricans
(drug therapy, etiology)
- Adolescent
- Adult
- Calcitriol
(analogs & derivatives, therapeutic use)
- Humans
- Hyperinsulinism
(complications, drug therapy)
- Hypoglycemic Agents
(therapeutic use)
- Insulin Resistance
- Metformin
(therapeutic use)
- Obesity
(drug therapy, etiology)
- Octreotide
(therapeutic use)
- Retinoids
(therapeutic use)
- Rosiglitazone
- Thiazolidinediones
(therapeutic use)
- Vitamin D
(analogs & derivatives, therapeutic use)
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