Treatment of HIV lipoatrophy and lipoatrophy of aging with poly-L-lactic acid: A prospective 3-year follow-up study - 24/04/13
Abstract |
Background |
Poly-L-lactic acid (PLLA), marketed as Sculptra (Dermik Laboratories, Bridgewater, NJ), is used for subcutaneous volume restoration. Durability studies are ongoing and longevity data are not yet available.
Objective |
We sought to evaluate the long-term efficacy and safety of PLLA during 3 years of follow-up.
Methods |
We conducted a prospective cohort study. Primary outcome measures were facial lipoatrophy score, complications, and patient satisfaction.
Results |
In all, 65 patients were initially treated with PLLA; 27 patients were HIV positive and 38 were HIV negative. Of those patients, 12 were lost to follow-up. Both HIV-positive and HIV-negative patients demonstrated statistically significant improvement in facial lipoatrophy score at the end of 3 years; HIV-positive patients had a net improvement of 2.50 points (P < .01) and HIV-negative patients had a net improvement of 1.11 points (P < .01) on the Facial Lipoatrophy Grading Scale. Subgroup analyses revealed no statistically significant difference in facial lipoatrophy score between years 2 and 3 among patients who did not receive treatment during the third year. Complications were rare and included subcutaneous papule formation, which improved spontaneously and partially responded to subcision in one patient.
Limitations |
Sample size was limited in this study. In addition, 12 of 65 patients (18%) were lost to follow-up between years 2 and 3.
Conclusions |
PLLA provides volumetric correction of HIV lipoatrophy and lipoatrophy of aging. Results appear to be long lasting and correction can be maintained for up to 3 years with additional treatment sessions. In a subset of patients, correction is maintained for at least 1 year after their last treatment session. Patient satisfaction with PLLA is high.
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Funding sources: None. |
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Disclosure: Dr Hanke is an investigator in a 5-year poly-L-lactic acid trial funded by Dermik Laboratories. Drs Levy and Redbord have no conflicts of interest to declare. |
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Portions of the data were presented at the Annual Meeting of the American Society for Dermatologic Surgery, Chicago, IL, October 14, 2007. |
Vol 59 - N° 6
P. 923-933 - décembre 2008 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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