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larger, longitudinal studies are needed to validate the observed ALC-cholesterol association and investigate causality regarding ASCVD risk

The corresponding author, Indar Sharawat of the All India Institute of Medical Sciences, did not respond to a request for comment, but his response on PubPeer states that their conclusions hold following a reanalysis

A more recent, larger study confirmed these results, finding that the rate of isotretinoin-induced acne flaring dropped significantly from 30% in those who received isotretinoin alone down to 5% in the group that took isotretinoin plus levocetirizine 2

However, given the variability in timing, protocol structure, and patient selection in the included studies, the authors acknowledged that beneficial effects in specific subgroups cannot be excluded and highlighted the urgent need for standardized treatment approaches