March 2011 | Volume 10 | Issue 3 | Feature | 324 | Copyright © 2011
Pipeline Previews brings to you information on the newest drugs and medical products as they become available to the dermatologic community. This department may include additional information from the manufacturers, plus reports from physicians who wish to share their clinical experience with these new products. In addition, we will inform our readers about the latest drugs receiving Food and Drug Administration (FDA) approval. We trust you will find this information beneficial to your practice and research.
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Herpes Zoster Vaccine Reduces Zoster Risk
The results of a new community-based study published in the January 12 issue of the Journal of the American Medical Association show that vaccination of adults older than 60 years with the herpes zoster vaccine (Zostavax, Merck & Co Inc.) reduced subsequent herpes zoster cases by about 50 percent compared with those not vaccinated, confirming the findings of clinical trials. A related study from CDC, to be published in the February issue of the American Journal of Preventive Medicine, shows that as of 2008, less than 7 percent of United States (U.S.) seniors had chosen to get the herpes zoster vaccine with particularly low vaccination rates of minorities.
The community-based study is based on data from patients enrolled in the Kaiser Permanente Southern California health plan, which has recommended the vaccine’s use in adults 60 years and older in the Kaiser system since 2007.
The researchers conducted a retrospective cohort study comparing the risk for herpes zoster among 75,761 plan members 60 years and older who received the vaccine with that of 227,283 unvaccinated age-matched members. Compared with the unvaccinated cohort, vaccine recipients were more likely to be white, to be women, and to have had more outpatient visits and a lower prevalence of chronic diseases.
Here, the authors present an 80-year-old white male treated with sorafenib for unresectable HCC who developed eight atypical squamous proliferations.
There were 5,434 herpes zoster cases identified in the study, 6.4 cases per 1,000 person-years among those vaccinated versus 13.0 cases per 1,000 person-years among unvaccinated individuals. In the fully adjusted analysis, vaccination was associated with a 55 percent reduced risk for herpes zoster.
- The full report can be found inJAMA. 2011;305:160-166.
Long-term Efficacy and Potencies of Botulinum Toxin A and B
The results of a prospective randomized double-blind study to compare short-term and long-term effects of Botox (BOT; Allergan Inc., Irvine, CA, U.S.A.) and Neurobloc/Myobloc (NBC; Solstice Neurosciences Inc., Malvern, PA, U.S.A.) in different doses and dilutions in a human skin model were recently published in the British Journal of Dermatology.
The study enrolled 18 volunteers (eight women and 10 men; mean±SD age 28.4±5.7 years) who were injected intra-dermally with pure saline, BOT and NBC at 10 points in the abdomen in random order, using the BOT/NBC conversion ratio 1:75 and different dilution schemes. The ninhydrin sweat test was used to compare the anhidrotic areas. Ten measurements were then taken over the course of 54 weeks.
Both preparations showed a peak effect at week 3, with significantly larger anhidrotic areas for NBC. After week 3, the rate of decline was lower in BOT, and after week 24, mean BOT areas were larger. The effect of dilution was higher in NBC and the mean dose equivalence conversion ratio (BOT/NBC) was 1:29 (area under the curve).
- The full report can be found inThe British Journal of Dermatology.2011;164(1):176-181.
Management of Pain Associated With Debridement of Leg Ulcers
A recent randomized, multicenter, open-label study indicates the advantage of the analgesic effect of lidocaine-prilocaine cream (LPC) application over nitrous oxide oxygen mixture (NOOM) inhalation during the mechanical repeated debridement of chronic arterial and venous leg ulcers. The results appear in the February 2011 edition of the Journal of the European Academy of Dermatology & Venereology.
The study enrolled 41 patients who were randomized with 20 receiving NOOM and 21 LPC. The pain experienced by the patients was evaluated before and after each care and debridement session using a Visual Analog Scale (VAS) and a Verbal Rating Scale (VRS), in the context of usual debridement and wound care process. The quality of debridement and tolerability of the treatments were also assessed.
The results of the study show that the pain experienced during mechanical debridement of chronic leg ulcers assessed by VAS and VRS was more intense in the NOOM group than in the LPC group (5.29 versus 3.68 and 2.87 versus 1.71, P<0.001, for the two scales respectively). No differences were found concerning quality of debridement, safety or tolerability between the two groups.