Spironolactone for acne treatment is not associated with an increased risk of deep venous thrombosis (DVT) or pulmonary embolism (PE), according to study results published in Journal of the American Academy of Dermatology.
Researchers conducted a retrospective cohort study to compare the risk for DVT or PE in patients with acne treated with spironolactone vs a tetracycline-class antibiotic such as doxycycline, minocycline, and sarecycline.
Data were obtained from the Truven Health MarketScan Commercial Claims database between January 1, 2017, and December 31, 2020. The database included patients from more than 160 large employers and health insurance plans in the United States.
Participants were women, had at least 1 acne diagnosis, and received a minimum of 60 days of treatment with spironolactone or a tetracycline-class antibiotic. Logistic regression was used to analyze the relationship between spironolactone use and tetracycline-class antibiotics on the probability of a PE or DVT occurring within 60 days.
A total of 33,543 participants who received spironolactone were matched with 33,543 participants who received a tetracycline-class antibiotic. The participants in both groups were a mean age of 30.9 (SD, 11.3) years, and 8.6% were currently receiving combined oral contraceptives.
Patients who were treated with spironolactone were not more likely to experience a DVT (odds ratio [OR], 0.57; 95% CI, 0.31-1.06) or PE (OR, 0.60; 95% CI, 0.26-1.37) compared with those who received tetracycline-class antibiotics.
Limitations of the study include the retrospective study design and the possibility of unmeasured confounding, although the use of matching and consideration of potential confounders, such as combined oral contraceptive use, reduced this risk.
“While there is a need to further study whether these findings generalize to other populations, this study provides reassurance that spironolactone use for acne is not associated with an increased risk for venous thromboembolism,” conclude the study authors.
Shields A, Flood K, Barbieri JS. Spironolactone use for acne is not associated with an increased risk of venous thromboembolism: a matched, retrospective cohort study. J Am Acad Dermatol. Published online February 24, 2023. doi: 10.1016/j.jaad.2023.02.028