Background: Glatiramer acetate (GA), an MS disease-modifying therapy, is administered as daily subcutaneous injections. The most common adverse effects, which occur in approximately 20-60% of the patients, include pain, inflammation and induration at the injection sites. Another adverse effect is frank panniculitis (inflammation of the fatty tissue under the skin) followed by localized lipoatrophy at the injection sites, which has been described in half of MS’ers receiving treatment with glatiramer acetate injections. No treatment has been found for established lipoatrophy.
“The following figures demonstrate what lipoatrophy looks like; it is the unsightly wasting of fatty tissue under the skin. This is a common cause for MS’ers stopping treatment with the drug. In my experience this is not unique to glatiramer acetate and also occurs with subcutaneous injections of interferon beta.”
Methods: All MS’ers underwent endermology twice a week during 30min. A cycle of two months was initially proposed. If the patient was satisfied with the result, sessions were continued with one session per week until the 4th month.
Results: 8 MS’ers treated with GA and presenting with lipoatrophy were prospectively recruited. None of them complained of any adverse events. After 8 weeks of treatment, all had a visible reduction of lipoatrophic area. MRI showed no major subcutaneous changes except for a reduction in and repartition of fatty tissues.
Conclusion: The endermology treatment stimulates the skin’s surface in triggering cells to activate lipolysis and collagen production. It has never been used for treatment of lipoatrophy due to drug treatment or in specific diseases associated with lipoatrophy, for example diabetes and HIV. The prevention and management of lipoatrophy includes patient education, regular examination and manual palpation of all injection sites. Endermology may help MS’ers deal with this side effect and allow them to continue immunomodulatory treatment.