Benefit of Endermology on Indurations and Panniculitis/Lipoatrophy During Relapsing–Remitting Multiple Sclerosis Long-Term Treatment with Glatiramer Acetate

• Published in: Advances in therapy Vol. 31; no. 8; pp. 904 - 914
• Main Authors: Márquez-Rebollo, Carmen, Vergara-Carrasco, Luisa, Díaz-Navarro, Rosa, Rubio-Fernández, Delia, Francoli-Martínez, Pablo, Sánchez-De la Rosa, Rainel
• Format: Journal Article
• Language: English
• Published: Heidelberg Springer Healthcare 01.08.2014; Springer
• Subjects: Adult; Biological and medical sciences; Cardiology; Dermatology; Endocrinology; Female; Glatiramer Acetate - administration & dosage; Glatiramer Acetate - therapeutic use; Health technology assessment; Humans; Immunosuppressive Agents - administration & dosage; Immunosuppressive Agents - therapeutic use; Injections - adverse effects; Internal Medicine; Long-Term Care; Male; Massage - methods; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Multiple Sclerosis, Relapsing-Remitting - drug therapy; Neurology; Oncology; Original Research; Panniculitis - etiology; Panniculitis - therapy; Pharmacology. Drug treatments; Pharmacology/Toxicology; Rheumatology; Skin involvement in other diseases. Miscellaneous. General aspects; Glatiramer acetate; Multiple sclerosis; Induration; Endermologie; Endermology; Lipoatrophy; Panniculitis; Skin disease; Nervous system diseases; Relapse; Long term; Inflammatory disease; Immunomodulator; Treatment; Central nervous system disease; Adipose tissue disorders
• ISSN: 0741-238X; 1865-8652
• DOI: 10.1007/s12325-014-0137-5

Introduction 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. Methods 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. Results 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. Conclusion 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.