Investigators screened 250 English-language studies that looked at 150 acne medications. Lehmann says there is controversy surrounding the inclusion of Accutane on the list because the review of English-language literature found the drug had never been tested against placebo.
Experts agree, however, on the effectiveness of the medication.
Alan Shalita, MD, a researcher in acne management, says initial testing on Accutane did not include placebo because investigators considered patients' needs. Accutane was pushed through because preliminary data from the National Institutes of Health found it was very effective against severe acne, says Shalita, who is a distinguished professor and chairman of the department of dermatology at the State University of New York in Downstate Brooklyn. There are other good acne drugs in the market that weren't included in the AHRQ report, adds Shalita. This report is based on certain very rigid criteria which are not necessarily applicable to all the drugs that are out there. Another expert, Daniel Krowchuk, MD, professor of pediatrics and dermatology at the Wake Forest University School of Medicine, agrees, noting that if the investigators of the review did not find good evidence on a drug, it may mean that either the medicine does not work or that a good study had not yet been done on it.