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Published Online, 15 August 2006, www.theannals.com, DOI 10.1345/aph.1G740.
 The Annals of Pharmacotherapy: Vol. 40, No. 9, pp. 1602-1606. DOI 10.1345/aph.1G740
© 2006 Harvey Whitney Books Company.
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HIV/AIDS

Poly-L-lactic Acid for Facial Lipoatrophy in HIV

Claudine El-Beyrouty, PharmD BCPS

Advanced Practice Pharmacist, Infectious Diseases, Thomas Jefferson University Hospital, Philadelphia, PA

Vanthida Huang, PharmD

Clinical Assistant Professor of Clinical and Administrative Services, Department of Clinical and Administrative Sciences, Southern School of Pharmacy, Mercer University, Atlanta, GA

Courtney J Darnold, PharmD Student

School of Pharmacy, University of Missouri—Kansas City University of Medicine and Biosciences, Kansas City, MO

Patrick G Clay, PharmD

Director, Dybedal Center for Clinical Research, Kansas City University of Medicine and Biosciences

Reprints: Dr. El-Beyrouty, Thomas Jefferson University Hospital, 111 S. 11th St., Philadelphia, PA 19107-4824, fax 215/955-9257, Claudine.el-beyrouty{at}mail.tju.edu

OBJECTIVE: To review the clinical data for poly-L-lactic acid, a synthetic polymer used as an intradermal injection for the treatment of HIV associated facial fat loss (lipoatrophy).

DATA SOURCES: A literature search was performed using MEDLINE (1966-August 2006). The search was limited to articles published in English and used the key words polylactic acid, polylactides, degradation, lipodystrophy, lipoatrophy, and HIV/AIDS. Dermik Laboratories was contacted to obtain unpublished information. Additional articles were retrieved from citations of selected references.

STUDY SELECTION AND DATA EXTRACTION: Relevant information on the pharmacology, pharmacokinetics, safety, and efficacy of poly-L-lactic acid from clinical trials were selected.

DATA SYNTHESIS: Poly-L-lactic acid (Sculptra) is a biocompatible, biodegradable, synthetic polymer able to be tailored into various desired morphologic features. It is approved by the Food and Drug Administration for the correction of facial lipoatrophy in people with HIV. Six clinical trials have evaluated the use of intradermal injections of poly-L-lactic acid. Results showed that cutaneous thickness is improved in patients receiving poly-L-lactic acid. Adverse effects included nodule and hematoma formation, as well as pain at the injection site.

CONCLUSIONS: Poly-L-lactic acid offers a treatment alternative for patients with HIV-associated lipoatrophy. Further research is required in nonwhite populations.

Key Words: lipoatrophy, polylactic acid

Published Online, August 15, 2006. www.theannals.com, DOI 10.1345/aph.1G740




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