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                                              AGOSTO 2.003

                                               AUGUST 2.003

  VALACYCLOVIR,  ISOTRETINOIN, NIMESULIDE, ORLISTAT, DUTASTERIDE, HEREDITARY POIKILODERMATOUS SYNDROMES

 

1.) FDA Approves Valtrex for Reducing Risk For Sexual Transmission With Suppressive Therapy.

2.) Investigan droga contra el acné (Roaccutan) en casos de depresión y suicidios.

3.) Mother of Suicidal Tampa Pilot Says She Will Sue Maker of Accutane

4.) Mother of 15-year-old Tampa suicide pilot blaming acne drug for boy's death.(Roaccutane)/ 147 intentos de suicidio reporta FDA !!!

5.) One year later, teen's mother, friend haunted by plane crash death./ Roche Demandado por 70 millones de dólares por madre del joven que se suicido al estrellar avioneta 

6.) Constipation, polyuria, polydipsia, and edema associated with orlistat/ (XENICAL.) efectos adversos.

7.) Orlistat e hipertensión / Xenical e hipertensión.

8.) INDIA: MEDICAMENTO VINCULADO A MUERTES DISPONIBLE EN EL MERCADO (NIMESULIDE= AULIN, AINEX, SCAFLAN)

9.) WHAT IS DUTASTERIDE (AVODART™ AVOLVE™) /Nueva medicina para la caída del cabello

10.) Synopsis of Hereditary Poikilodermatous syndromes

 

1.)  FDA Approves Valtrex for Reducing Risk For Sexual Transmission With Suppressive Therapy.  

 FDA Updates Labeling of Valtrex source: Aug 29, 2003 FDA Talk Paper

Source: https://www.natap.org/

The Food and Drug Administration (FDA) has approved a new indication for Valtrex (valacyclovir hydrochloride) Caplets; Valtrex reduces the risk of heterosexual transmission of genital herpes to susceptible partners with healthy immune systems when used as suppressive therapy in combination with safer sex practices.

Genital herpes is a common sexually transmitted infection caused by herpes simplex viruses (HSV). Many individuals have no or only minimal signs or symptoms from genital HSV infection and may transmit the virus during sexual contact when they show no signs of active infection (i.e. genital lesions).

The following safer sex practices can also lower the chances of passing genital herpes to a partner:

--Use a condom made of latex or polyurethane when you have sexual contact. --Do not have sexual contact with your partner when you have any symptom or outbreak of genital herpes.

FDA based its decision to revise the labeling for Valtrex on the results of an international, double-blind, placebo-controlled clinical trial conducted by the manufacturer, GlaxoSmithKline (GSK) of Research Triangle Park, N.C. The study was conducted among about 1500 monogamous, heterosexual couples and lasted eight months. At the beginning of the study, only one member in each couple had evidence of genital herpes. The results of the GSK study showed a 48% reduction in HSV acquisition; individual results may vary based on consistency of safer sex practices.

Valtrex may cause kidney problems in some people. In addition, Valtrex may cause nervous system problems; these include aggressive behavior, unsteady movements, shaky movements, confusion, speech problems, hallucinations, seizures and coma. Kidney and nervous system problems have happened in patients who already have kidney disease and in elderly patients whose kidneys do not work well due to age. Therefore, it is important for patients to tell their healthcare providers if they have kidney problems or other medical conditions before taking Valtrex.

Today’s action follows the recommendation of FDA’s Antiviral Drugs Advisory Committee, which met on May 14, 2003, to discuss GSK’s then-proposed use of Valtrex for reduction of the risk of transmission of genital herpes with the use of suppressive therapy. FDA first approved Valtrex in 1995.

To read report on FDA Hearing and review of study results:

Valtrex For Reducing Transmission of Genital Herpes- FDA Hearing: FDA panel votes 11-0 to recommend approval https://www.natap.org/2003/may/051503_1.htm

CLINICAL TRIALS Herpes Zoster: Two randomized double-blind clinical trials in immunocompetent adults with localized herpes zoster were conducted. VALTREX was compared to placebo in patients less than 50 years of age, and to ZOVIRAX in patients greater than 50 years of age. All patients were treated within 72 hours of appearance of zoster rash. In patients less than 50 years of age, the median time to cessation of new lesion formation was 2 days for those treated with VALTREX compared to 3 days for those treated with placebo. In patients greater than 50 years of age, the median time to cessation of new lesions was 3 days in patients treated with either VALTREX or ZOVIRAX. In patients less than 50 years of age, no difference was found with respect to the duration of pain after healing (post-herpetic neuralgia) between the recipients of VALTREX and placebo. In patients greater than 50 years of age, among the 83% who reported pain after healing (post-herpetic neuralgia), the median duration of pain after healing [95% confidence interval] in days was: 40 [31, 51, 43 [36, 55], and 59 [41, 77] for 7-day VALTREX, 14-day VALTREX, and 7-day ZOVIRAX, respectively.

Genital Herpes Infections: Initial Episode: Six hundred and forty-three immunocompetent adults with first episode genital herpes who presented within 72 hours of symptom onset were randomized in a double-blind trial to receive 10 days of VALTREX 1 gram twice daily (n = 323) or ZOVIRAX 200 mg 5 times a day (n = 320). For both treatment groups: the median time to lesion healing was 9 days, the median time to cessation of pain was 5 days, the median time to cessation of viral shedding was 3 days.

Recurrent Episodes: Three double-blind trials (2 of them placebo-controlled) in immunocompetent adults with recurrent genital herpes were conducted. Patients self-initiated therapy within 24 hours of the first sign or symptom of a recurrent genital herpes episode. In 1 study, patients were randomized to receive 5 days of treatment with either VALTREX 500 mg twice daily (n = 360) or placebo (n = 259). The median time to lesion healing was 4 days in the group receiving VALTREX 500 mg versus 6 days in the placebo group, and the median time to cessation of viral shedding in patients with at least 1 positive culture (42% of the overall study population) was 2 days in the group receiving VALTREX 500 mg versus 4 days in the placebo group. The median time to cessation of pain was 3 days in the group receiving VALTREX 500 mg versus 4 days in the placebo group. Results supporting efficacy were replicated in a second trial.

In a third study, patients were randomized to receive VALTREX 500 mg twice daily for 5 days (n = 398) or VALTREX 500 mg twice daily for 3 days (and matching placebo twice daily for 2 additional days) (n = 402). The median time to lesion healing was about 4.5 days in both treatment groups. The median time to cessation of pain was about 3 days in both treatment groups.
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2.) Investigan droga contra el acné (Roaccutan) en casos de depresión y suicidios

El medicamento se comercializa en Chile bajo receta médica retenida
Source: https://www.geocities.com/econatsalud/noticias/

Pedro Vicario

Caso del joven norteamericano que estrelló su avioneta contra un edificio en EE.UU., quien se presume consumía el medicamento, revivió dudas contra el fármaco.
Charles Bishop, el adolescente de 15 años que el pasado sábado -emulando los atentados al World Trade Center- estrelló un avión Cessna contra el edificio del Bank of America Plaza en Tampa, Florida, era un joven normal. Tan normal que tenía los problemas propios de los jóvenes de su edad. En el hogar del novel piloto fue encontrada una receta prescrita a su nombre con el fármaco Accutane, versión norteamericana del medicamento vendido en Chile Roacutan, que se usa comúnmente para el tratamiento del acné juvenil.

El hecho volvió a sacar al tapete el tema de los riesgos que esta droga pudiera tener en la población. A las ya conocidas contraindicaciones a embarazadas por riesgo de malformaciones y muertes de sus hijos (advertidas debidamente en su envase), se agrega la sospecha de que el fármaco pudiera ocasionar depresión e incluso intentos de suicidio. Ese podría ser el caso del joven kamikaze norteamericano quien, a juzgar por la receta encontrada en su casa, era un típico consumidor de la droga.

El Accutane -su nombre genérico es isotretinoína- se vende en Chile con receta médica retenida bajo el nombre de Roacutan. El laboratorio Roche, productor del fármaco, aclaró a través de la vicepresidenta del laboratorio farmacéutico Hoffman-La Roche, Carolyn Glynn, que la empresa estaba tomando el caso “muy seriamente”. “Ciertamente que vamos a analizar este caso detenidamente” agregó Glynn, ante la magnitud que pudiera tomar el problema, tomando en cuenta que el medicamento es recetado a pacientes de todo el mundo.

¿Qué pasa en Chile?

Según el psiquiatra José Bitrán, el ha tenido dudas respecto de pacientes puntuales que han tomado el Roacutan. “El paciente de uno que tiene problemas anímicos y a su vez es un adolescente, en la mitad del tratamiento empieza a tomar el fármaco, comienzan ha empeorar los síntomas y se genera un entorpecimiento de la evolución del cuadro” opinó.

Concordó en que si bien no se puede afirmar que el Roacutan sea la causa del problema, ya que no existen estudios científicos al respecto, si se logra establecer una relación entre casos de depresión y uso del fármaco.

Héctor Fuenzalida, dermatólogo del Hospital Clínico de la Universidad de Chile, recomendó antes de recetarlo “tener la precaución, en pacientes con depresión o esas características, de recetar el Roacutan. Yo dudaría en hacerlo o quizás controlaría la dosis del fármaco mucho más seguido, con un apoyo psiquiátrico detrás”.

El médico, que si bien prefirió relacionar la depresión a la baja autoestima que genera el acné, dijo que ante la duda es mejor tomar en cuenta las críticas que existen sobre el medicamento. Esto pese a que el fármaco “es un medicamento aprobado por la FDA y cumple todas las normas” concluyó el especialista.

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3.) Mother of Suicidal Tampa Pilot Says She Will Sue Maker of Accutane / Madre del joven que se suicido intentara acción legal contra el fabricante de Accutane (Roche).

Source: https://www.injuryboard.com/

April 16, 2002

The mother of Charles Bishop, the 15-year-old pilot who committed suicide on January 5 by flying a stolen Cessna into a Tampa high rise, says Accutane is responsible for her son's death. Julie Bishop recently told reporters in an interview that because her son had shown no signs of depression before the crash, "the only conclusion we have been able to draw is the Accutane poisoned him." Bishop said she plans to file suit against the drug's maker.

A prescription for Accutane, made by Hoffman-La Roche, was found in Bishop's home during a police search shortly after the crash. Although an autopsy did not find trace amounts of Accutane in Bishop's blood, critics claim that the controversial medication can have "depressive effects on the brain" weeks after a person stops using it.

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4.) Mother of 15-year-old Tampa suicide pilot blaming acne drug for boy's death / 147 pacientes reporta FDA con intentos de suicidio por Roaccutane desde su debut en el mercado.

Source: https://www.injuryboard.com/

April 17, 2002, Wednesday

Associated Press
By VICKIE CHACHERE

The maker of the acne drug Accutane faces a $70 million lawsuit claiming the medicine caused severe psychosis in a 15-year-old boy who crashed a stolen plane into a Tampa high-rise. The lawsuit, filed against Hoffmann-La Roche on Monday by the family of Charles Bishop, blames Accutane for the boy's suicide. Bishop slammed the small plane into the high rise on Jan. 5 and left behind a note expressing sympathy for Osama bin Laden and supporting the Sept. 11 attacks.

In an interview aired Tuesday by NBC's ``Today'' show, the boy's mother, Julia Bishop, said her son had showed no signs of depression.

``This child was a happy, well-balanced, forward-thinking child who had a great deal to live for,'' Bishop said. ``This was psychotic and the only conclusion we have been able to draw is the Accutane poisoned him.''

A Hoffmann-La Roche spokeswoman said the company was unaware of the lawsuit and does not believe the drug is dangerous.

Accutane carries a warning about suicide, but the company points to statistics showing sufferers of severe acne and teen-agers the main users of the drug generally have higher suicide rates.

``We continue, as do the experts, to believe there is no link,'' said company spokeswoman Carolyn Glynn.

The Food and Drug Administration says 147 people taking Accutane either committed suicide or were hospitalized for suicide attempts from 1982 to May 2000. An estimated 13 million patients have used Accutane since its debut in 1982.

An autopsy found no trace of Accutane in Bishop's blood, but attorneys for the family say so much blood was lost in the crash that the test may not have been useful.


Department of Diagnostic Sciences and Pathology, Dental School, University of Maryland, Baltimore 21201-1586, USA. [email protected]

BACKGROUND: The authors provide clinical findings in five patients wearing oral jewelry to illustrate the risks of experiencing periodontal injury associated with body piercing involving intraoral and perioral sites. They also present a literature review of other adverse dental and medical consequences attributed to oral piercing.

CASE DESCRIPTIONS: Five young adult patients with tongue and lip piercing sought dental care. Each patient exhibited some degree of gingival recession and mucogingival defects in proximity of their oral jewelry. Three of these patients had probing depths ranging from 5 to 8 millimeters in the affected areas.

CLINICAL IMPLICATIONS: Intraoral and perioral jewelry may be associated with the development of significant mucogingival deformities. Because severe attachment loss can develop even when gingival recession is minimal, it is critical that patients with oral piercing routinely undergo comprehensive periodontal assessment. The authors urge clinicians to educate patients about the potential risks regarding the practice of oral piercing.

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5.) One year later, teen's mother, friend haunted by plane crash death/Madre de joven que murió al estrellar avioneta demanda al laboratorio Roche por 70 millones de dólares !!!

Source: https://www.injuryboard.com/

Associated Press
January 06, 2003, Monday

One year after 15-year-old Charles Bishop crashed a stolen airplane into a Tampa skyscraper, his mother and best friend said they are still haunted by death and struggling with the public attention it has drawn. Julia Bishop, who has filed a $70 million lawsuit against the maker of the acne medication Accutane that her son was taking before the crash, has made few public statements since her son's death Jan. 5, 2002.

``This is a news story for the rest of the world,'' she told the St. Petersburg Times in a story for Sunday's edition. ``But for me, he was my life and my son and it's extremely difficult to have this thrown into my face all the time.''

Bishop is limited in what she can talk about because of the lawsuit, which contends Accutane caused the boy to develop severe psychosis and led him to commit suicide. A trial is set for March 2004 in U.S. District Court in Tampa.

Julia Bishop remembers her son, a high school freshman who dreamed of becoming an Air Force Pilot, excitedly talking about an upcoming trip to Australia and New Zealand as a student ambassador.

Days later, he left a two-page note, expressing sympathy for Osama bin Laden and supporting the Sept. 11, 2001, terrorist attacks. He also claimed he had resisted recruiting attempts by al-Qaida terrorists.

``When you see a pattern and then suddenly for somebody to snap and think they are working for Osama bin Laden ... I'm sure you've seen the note,'' Julia Bishop said. ``That's really sick.''

Julia Bishop said she meets about once a month with her son's best friend, Emerson Favreau, who says he still feels guilty he didn't notice any suicide warning signs in his friend.

Two days before the crash, Charles sent Favreau an e-mail saying he was going to be on the news. Charles ended the online conversation by saying: ``See you Monday.''

``That's what made me mad,'' Favreau said. ``Because he knew he wasn't going to see me on Monday.''

Favreau has re-created his friend's final flight along Tampa's skyline on an airplane computer simulator.

``I was trying to figure out maybe if there was something going on,'' Favreau said. ``I still couldn't believe that he did it on purpose.''

Emerson said he was finally convinced by a federal report in November that said Bishop flew dangerously close to the MacDill Air Force Base control tower before crashing into the 42-story Bank of America Plaza in downtown Tampa.

``Before, there was nothing concrete that he had done it on purpose,'' Favreau said. ``But you can't accidentally (buzz a control tower) with a Cessna.''

Now a junior at East Lake High School, Favreau said students don't talk much about Charles Bishop anymore, but that he is still haunted by the suicide.

``It's just something that you can't get off your head,'' Favreau said.

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6.) Constipation, polyuria, polydipsia, and edema associated with orlistat/ (XENICAL.) efectos adversos.
Ann Pharmacother. 2002 Jul-Aug;36(7-8):1168-70.

Packard KA, Wurdeman RL, Reyes AP.

Creighton Cardiac Center, Omaha, NE 68131-2044, USA. [email protected]

OBJECTIVE: To report the occurrence of a novel group of adverse effects associated with initiation and rechallenge of orlistat.

CASE SUMMARY: A 42-year-old white woman developed symptoms of constipation, polyuria, polydipsia, and increased lower-leg edema after 2 weeks of treatment with orlistat 120 mg 3 times daily. The drug was discontinued for 4 days and the symptoms resolved. On reinstitution of the orlistat treatment, the symptoms reappeared within 2 days. Thereafter, the medication was permanently discontinued.

DISCUSSION: Common gastrointestinal adverse reactions associated with orlistat use include fecal urgency and abdominal pain and discomfort. Pedal edema has also been reported to occur, although less frequently. No reports were discovered documenting the occurrence of constipation, polydipsia, and polyuria associated with the use of orlistat.

Despite careful consideration of other possible causes of these symptoms, the temporal association between initiation, discontinuation, and rechallenge of orlistat and the patient's symptoms suggest a medication-related adverse event. Based on the Naranjo probability scale, the likelihood that orlistat was the cause of this cluster of adverse effects is possible.

CONCLUSIONS: It is important for the healthcare provider to be aware of these adverse effects to promptly evaluate and differentiate between possible causes of similar reactions.

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 7.) Orlistat e hipertensión / Xenical e hipertension.

Source: https://www.fonendo.com/ British Medical Journal 10/07/2000

El centro de Farmacovigilancia suizo ha reportado un caso de una paciente que hubo de retirar el fármaco por HTA.
Sin antecedentes de interés, comenzó el fármaco hasta llegar a una dosis de 120 mg/8 h. Comenzó a presentar mareo, edemas periféricos y cefalea pulsátil, constatándose unas cifras de TA de 190/100 mm Hg en tres ocasiones.

Tras retirar el fármaco, volvió a sus cifras normales. Tras reintroducirlo, volvió a presentar la misma sintomatología, por lo que se retiró definitivamente. La paciente se volvió a recuperar.

El fabricante había comunicado 13 casos previos de HTA, pero la información era incompleta. Aún no disponemos de recomendaciones al respecto, pero quizás sea necesario controlas las cifras de TA en los pacientes en tratamiento.


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8.) INDIA: MEDICAMENTO VINCULADO A MUERTES DISPONIBLE EN EL MERCADO (NIMESULIDE= AULIN, AINEX, SCAFLAN)

Source:
https://www.boletinfarmacos.org/

Sanjay Kumar, BMJ, 2003; 326:70

El nimesulide, un anti-inflamatorio no esteroideo, se ha retirado de muchos mercados europeos pero sigue estando disponible en India. Se sabe que es un medicamento hepatotóxico y que ha provocado la muerte a varios niños. La India aprobó este medicamento en 1994 para uso en casos de inflamación musculoesquelética, sin embargo se utiliza frecuentemente como analgésico y antipirético.

Según el Dr Chandra Mohan Gulhati, editor del Boletín de Información sobre el Medicamento de India, el medicamento no está aprobado en EE.UU., Canadá, Australia, y partes de Europa; y Finlandia, España y Turquía lo retiraron del mercado el año pasado.

Después de que los medios de comunicación denunciaran el hecho, el responsable de controlar los medicamentos en India, Ashwini Kumar, dijo que el gobierno designaría a un comité de expertos para que estudiase el problema. El asistente del Sr. Kumar, Ram Teke, dijo a BMJ que el medicamento sigue estando disponible y que no había intención de reconsiderar su utilización o de retirarlo del mercado. El volumen de ventas de este medicamento es del orden de 1900 millones de rupíes (39,5 millones de dólares).

El nimesulide además de estar disponible como producto activo único, también esta presente en otros 30 medicamentos y en gotas para niños menores de un año. Todas estas combinaciones son ilegales porque no cuentan con el registro correspondiente.

El Dr. Gulhati dice que no hay un buen sistema para informar sobre reacciones adversas en India. Hay 12 medicamentos que se han retirado de los mercados globales, o que son de prescripción limitada, que están disponibles en la India, estos son: anagen, cerivastatina, droperidol, furazolidone, lynestrenol, nitrofurazona, fenformin, fenolftaleina, fenilbutazona, piperazina, y quiniodoclor.

Es más, cuando se decide retirar un medicamento del mercado, la implementación de esta decisión es muy deficiente, dijo el Dr Gulhati. Por ejemplo, en junio pasado se tomo la decisión de retirar los antialérgicos astemizole y terfenadine; la notificación no se hizo hasta octubre y en ella se indicaba que no se retirarían hasta agosto del 2003.

Según el Dr. Gulhati los medicamentos deberían retirarse del mercado tan pronto como se determina que son nocivos, y la única explicación plausible es que hay interés en proteger a la industria. Dice que las decisiones de la autoridad reguladora están afectadas por los intereses comerciales de los cabilderos de la industria y la corrupción; y que es una autoridad a la que no se le exige transparencia ni que justifique sus actividades.

Las acciones de los medios de comunicación han provocado que dos laboratorios recorten sus volúmenes de producción de nimesulide.

Ajay Kumar Handa, presidente de marketing para Centaur Pharmaceutical, dijo: " Ya no estamos produciendo jarabe de nimesulide." Y añadió “Por lo que yo sé no hay problemas con la administración de este medicamento a adultos.”

El grupo Social Jurist presentó un caso a la Corte Suprema de Delhi donde cuestiona la disponibilidad de nimesulide y de otros medicamentos que se han retirado de otros mercados pero que siguen estando disponibles en India.

Krezel W, Ghyselinck N, Samad TA, et al. Impaired locomotion and dopamine signaling in retinoid receptor mutant mice. Science. 1998;279:863-867.

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9.) WHAT IS DUTASTERIDE (AVODART™ AVOLVE™) /Nueva medicina para la caída del cabello !!!

Source: https://www.dutasteridedirect.com/

Dutasteride (Avodart, Avolve) - a new, emerging treatment for hair loss DutasterideDIRECT.com is your online source for news and information on the latest treatments for hair loss. This FAQ has been compiled from a number of sources to give an overview of the use and effects of Dutasteride.

What is Dutasteride (Avodart, Avolve)?

Avolve is the European brand name for Dutasteride, an oral medicine made by GlaxoSmithKline for treating symptomatic benign prostatic hyperplasia (BPH) in men.

The active compound in Avolve, Dutasteride, has the added benefit of treating genetic male pattern hair loss on the vertex (top of the head) and the mid-scalp area. Dutasteride is chemically similar to Finasteride, the active compound in Propecia.

Avolve is also known by its US brand name, Avodart. The medicine has been approved by the US Food & Drug Administration, and in Europe, for treating BPH. Avolve is supplied in 0.5mg soft gelatin capsules.

How does Avolve work?

Researchers have discovered that men who suffer from benign prostatic hyperplasia (BPH), or from male pattern hair loss, have increased levels of the hormone dihydrotestosterone (DHT).

DHT is produced from testosterone by an enzyme called 5-alpha-reductase. Biochemical analysis reveals higher levels of 5-alpha-reductase in the bloodstream of men with BPH, and in the scalps of men with hair loss; and less of this enzyme in men with no BPH or no hair loss.

Avolve inhibits 5-alpha-reductase, blocking the formation of DHT. This interrupts a key trigger element in both BPH and development of male pattern hair loss.

What is dihydrotesterone (DHT)?

DHT is one of several male hormones in the body. DHT is responsible for the development of the external genitals in the male foetus. However, in adult males DHT appears to cause:

male pattern hair loss
prostate enlargement
shortening of the growing phase of hair
progressive miniaturisation of hair follicles
decreasing number of visible hairs
acne

How is Avolve different from Propecia?

Both medicines work in a similar way. However, Avolve (Dutasteride) inhibits the activities of two types of 5-alpha-reductase enzymes. In contrast, Propecia (Finasteride) only inhibits one type. Avolve has been shown to decreases levels of DHT by 90% after only two weeks, making it a more powerful and faster-acting weapon against BPH and hair loss than Finasteride.

What studies and trials have been done concerning Avolve?

A total of 2951 men with moderate to severe BPH were treated with 0.5 mg Avolve (dutasteride) daily. The study found that acute urinary retention was reduced by 57%, and the risk of benign prostatic hyperplasia-related surgical intervention was cut by 48% compared with placebo. The drug was shown to be well tolerated.

GlaxoSmithKline also completed Phase II trials for FDA approval of Avolve for treating hair loss. After six month of treatment, the hair counts measured in a 1 inch diameter circle increased by an average 96 hairs with 0.5mg Avolve daily, compared to an average 72 hairs with 5mg Propecia (Finasteride) daily.

So these initial trials show that Avolve is around 30% more effective than Propecia in promoting hair regrowth. However, please note that Avolve has only been specifically approved for treating BPH. It has not yet been approved specifically for treating hair loss.

When will Avolve be approved for treating hair loss?

In November 2002 GlaxoSmithKline cancelled its planned Phase 3 trials for Avolve for treating hair loss. The company has not publicly given a reason for this. Industry sources speculate that the trials were stopped because the maker thinks Avolve will be perceived as too similar to Propecia in consumers' minds, and may not generate sufficient return on investment to justify the cost of the approvals process as a treatment for hair loss.

However, Avolve is approved by the US FDA and by European bodies for the treatment of BPH, and so has passed all relevant safety standards.

Will Avolve help hair re-growth for all men?

As with Propecia, Avolve increases the number of scalp hairs, helping to fill-in thin areas of the scalp. Although results will vary, generally men will not re-grow all of the hair they have lost. Male pattern hair loss occurs gradually over time, but Avolve can significantly reduce or delay hair loss. Note that Avolve is not yet approved for treating hair loss: its effects are a side-effect of its actions against BPH.

Is Avolve safe?

Clinical trials showed that it was generally well tolerated. Most side effects were mild or moderate and generally went away while on treatment in both the Avolve and placebo groups.

Drug-related side effects during the first six months were as follows:

impotence (4.7% vs. 1.7% for placebo)
decreased libido (3% vs. 1.4%)
breast tenderness and breast enlargement (gynecomastia; 0.5% vs. 0.2%)
ejaculation disorders (1.4% vs. 0.5%).

Avolve should not be used in women and children. Women who are pregnant or may become pregnant should not handle this medicine because of possibility of absorption and subsequent potential risk to a male foetus.

Men treated with Avolve should not donate blood until at least six months after their final dose to prevent the medicine going to a pregnant woman through a blood transfusion.

Men with liver disease should talk to their doctor before taking Avolve.

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1O.) Synopsis of Hereditary Poikilodermatous syndromes.

Khalid Al Aboud,M.D

Khalid Al Hawsawi,M.D

Dermatology division,Department of Medicine,King Faisal Hospital,Taif,Saudi Arabia

Address of corressopndence :Khalid Al Aboud,M.D,P.O Box 5440

Makkah,Saudi Arabia,Tel 966 2 7382444,Fax 966 2 7384719,e-mail [email protected]

Aging of the skin is a physiological process.However,there are a groups of diseases that cause aging of the skin.One of these group is hereditary poikilodermatous syndromes.It is characterixed by affection of the skin by ,pigmentary changes(both hypo and hyperpigmentation),atrophy and telangectasias(fig .1)

This group include:

·                      Rothmund- Thomson Syndrome.

·                      Dyskeratosis Congenita.

·                      Xeroderma Pigmenosum.

·                      Kindler Syndrome.

·                      Epidermolysis Bullosa Simplex Variants.

Table I provide a synopsis  for the main diseases in this group.

 Table I:Synopsis of the main hereditary poikilodermatous syndromes.

DISEASE

INHERITANCE

ONSET

SKIN

HAIR

NAIL

TEETH & MUCUS MEMBRANES

OHTERS

Rothmund Thomson syndrome (rothmund 1868)

A.R

3-6 M ERYTHEMA BLISTERS ON FACE LIMBS

POIKILODERMA

SPARSE

-

ABNORMAL DENTITION

CATARACT SKELETAL ABNORMAL ALITIES

Xeroderma pigmenosum & Herbal( Jkaposi 1874)

A.R

6M-3Y ERYTHEMA &THEN FRECKLING

NEOPLASIA PHOTOSENSITIVITY

-

-

Oral CA

EYE &CNS INVOLVMENT

Dyskeratosis Congenita (Zinsser 1906)

X-Linked recessive.A.D

5-13 Y NAILS DYSTROPHILES

POIKILODERMA  (neck)

-

+

LEUKOKERATOSIS. à ANORECTAL & URETHRAL STENOSIS

HAEMATOL.OGICAL DISORDERS, NEOPLASIA.

KINDER SYNDROM (KINDLER 1954)

A.R

BIRTH: BLISTERS

PHOTOSENSITIVE WEBBING OF FINGERS

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+

PERIODENTITIS  LEUKOKERATOSIS. ANORECTAL &URETHRAL STENOSIS

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WEARY SYNDROME WEAR(JET AL 1971)

A.D

INFANCY: VESICULOPUSTULES OF HANDS

ECZEMA (4 M – 5Y) SCLEROTIC BANDS PUNCTATE PPK

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-

PERIODENTITIS

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Figure 1:poikilodermatous skin changes in a patient with Kindler syndrome.

 

Cambios en la piel poililodermatosa en una paciente con síndrome de Kindler.

 

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DATA-MÉDICOS/DERMAGIC-JOURNAL /AUGUST  2.003/ DR. JOSÉ LAPENTA
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Produced by Dr. José Lapenta R. Dermatologist  
Maracay Estado Aragua Venezuela 2003-2026
Telf.: 04142976087 - 04127766810