Long-Term Topical Tretinoin and Excess Mortality in Older Patients

Topical tretinoin therapy was associated with increased mortality, but current evidence suggests a causal association is unlikely.

The possibility that nonmelanoma skin cancers might be prevented by use of topical and systemic retinoids has long been of interest, although few data are available on use in patients with extensive actinic damage. Recently, investigators conducted a placebo-controlled, double-blind, multicenter clinical trial to evaluate the efficacy and safety of 0.1% tretinoin cream in subjects at risk for nonmelanoma skin cancers. Sponsored by the U.S. Department of Veterans Affairs, the study enrolled 1131 veterans at six sites throughout the United States (95% men; mean age, 71). Subjects were instructed to apply 0.1% tretinoin cream to the face and ears up to twice daily, depending on tolerance, for 2 to 6 years.

The study was terminated 6 months earl…

Reviewing Author

Craig A. Elmets, MD

Disclosures

Consultant / Advisory board Astellas Pharmaceuticals

EquityVaxin

Grant / Research support NIH; NIH/NCI; Veteran’s Administration; Ferndale Laboratories; Kyowa Hakko Kirin Pharma, Inc.

Editorial boards Cancer Prevention Research; Photodermatology, Photoimmunology, & Photomedicine; UpToDate; eMedicine; Journal of Dermatological Sciences; JAMA Dermatology

Leadership positions in professional societies American Academy of Dermatology (Vice Chair, Committee on Science and Research); Photomedicine Society (Board of Directors)