Benefit of Endermology on Indurations and Panniculitis/Lipoatrophy During Relapsing–Remitting Multiple Sclerosis Long-Term Treatment with Glatiramer Acetate
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Use of endermology (Endermologie®), which consists of a deep mechanical massage, in patients with multiple sclerosis receiving glatiramer acetate suggested improvements in injection-site indurations and panniculitis/lipoatrophy in our previous pilot experience. We aimed to assess the effect of endermology in a larger population of patients with multiple sclerosis receiving glatiramer acetate in clinical practice.
This was the extension phase of our pilot experience, carried out in patients with relapsing–remitting multiple sclerosis (RRMS) and indurations and/or panniculitis/lipoatrophy associated with long-term glatiramer acetate administration. Patients underwent endermology sessions twice per week, for 6 weeks, according to clinical practice.
Seventy evaluable patients were included (mean age, 42.7 ± 9.3 years; female, 95.7%; mean multiple sclerosis duration, 9.2 ± 8.6 years; mean glatiramer acetate duration, 46.7 ± 29.9 months). Fifty (71.4%) patients showed indurations and 58 (82.9%) panniculitis/lipoatrophy. After 12 endermology sessions, the number of patients with indurations significantly decreased (71.4% vs. 28.6%; p < 0.001), as did the number of their indurations (4.2 ± 3.6 vs. 3.7 ± 3.4; p < 0.001). Although the number of patients with panniculitis/lipoatrophy did not significantly decrease, there was a significant reduction in the number of areas of panniculitis/lipoatrophy (4.3 ± 2.6 vs. 3.9 ± 2.2; p < 0.05). Forty-nine (98.0%) patients with indurations and 57 (98.3%) patients with panniculitis/lipoatrophy felt satisfied/very satisfied with treatment and considered endermology useful/very useful. Endermology was well tolerated, as some pain was reported in eight (11.4%) patients, discomfort in three (4.3%) patients, and local blotch/swelling and transient bruise in one (1.4%) patient each. Endermology enabled glatiramer acetate tolerance to be enhanced in 42 (60.0%) patients.
This project represents the largest experience available supporting the benefit of endermology in the reduction/disappearance of indurations and improvement in panniculitis/lipoatrophy in patients with RRMS receiving long-term glatiramer acetate treatment. Moreover, these benefits also contributed to enhancing glatiramer acetate tolerance.
KeywordsEndermologie Endermology Glatiramer acetate Induration Lipoatrophy Multiple sclerosis Panniculitis
Sponsorship and article processing charges for this project were funded by Teva Pharma Spain. We acknowledge the following people for their participation in the project: Jaime Cordero, Leonor Rubio-Hidalgo and Mª Rosario Coll-Carreño at Hospital Regional Universitario Carlos Haya (Málaga, Spain); Agueda Poyato-Roca at Hospital General Universitario Santa Lucía (Cartagena, Spain); Javier Cano-Martínez at Hospital General Universitario Morales Meseguer (Murcia, Spain); Carmen Calles at Hospital Universitari Son Espases (Mallorca, Spain); Clara Rodríguez-del Canto, Héctor Edreira and Lidia Sevane-Fernández at TEVA Pharma S.L.U. (Alcobendas, Spain); Claudio J. Sarabia and Emilio Laveda at Clínica Asestetic Asesoria Médico Estética Integral S.L. (Murcia, Spain). Editorial assistance in the preparation of this manuscript was provided by Esther Álvarez-García and Antonio Torres-Ruiz of Dynamic S.L., and was funded by Teva Pharma Spain. All named authors meet the ICMJE criteria for authorship for this manuscript, take responsibility for the integrity of the work as a whole and have given final approval to the version to be published. Rainel Sánchez-De la Rosa is the guarantor for this article. The project data was partially presented in a poster session at: XX Congreso Anual de la Sociedad Española de Enfermería Neurológica: Barcelona (Spain), November 21th–22th, 2013.
Conflict of interest
CM has acted as a board member for Merck and has received honoraria as a consultant and speaker fees and support for traveling to meetings from the following companies: Novartis, Biogen, Merck, Teva, Glaxo, and Genzyme. LVC has acted as a board member for Teva and has received honoraria as a speaker for Novartis, Biogen, Merck, and Teva. RDN has received honoraria as a consultant and speaker fees and support for traveling to meetings from: Novartis, Biogen, Merck, Teva, Glaxo, and Genzyme. DR has received honoraria as a consultant and speaker fees and support for traveling to meetings from the following companies: Novartis, Biogen, Merck, Teva, Glaxo, and Genzyme. PFM is an employee of Teva Pharma Spain, who works at the Medical and HEOR Department. RSR is an employee of Teva Pharma Spain, who works at the Medical and HEOR Department.
Compliance with ethics guidelines
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008. Informed consent was obtained from all patients included in the project.
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