title: Contribution of endermology to improving indurations and panniculitis/lipoatrophy at glatiramer acetate injection site.
abstract: BACKGROUND
  Endermology is a mechanical massage therapy that enables fat mobilization and body contouring. The authors' aim was to assess the effect of endermology on indurations and panniculitis/lipoatrophy associated with subcutaneous administration of glatiramer acetate in patients with multiple sclerosis (MS).
  
  
  METHODS
  This was a multicenter pilot experience carried out in patients with MS treated with glatiramer acetate who showed indurations and/ or panniculitis/lipoatrophy at the injection site. Patients underwent endermology and glatiramer acetate treatment according to clinical practice. The primary endpoint was the change in indurations and/or panniculitis/lipoatrophy after 12 endermology sessions.
  
  
  RESULTS
  Between April and July 2011, a total of 13 evaluable patients were included (mean age, 40.7±3.1 years; female, 100%; white, 100%; mean MS duration, 10.1±2.3 years; previous MS treatment, 46.2%; mean glatiramer acetate treatment duration, 27.3±9.5 months). Eleven patients (84.6%) showed local indurations (mean diameter, 3.4±0.5 cm; mean number, 9.0±1.0) and six patients (46.2%) areas of panniculitis/ lipoatrophy (mean number, 5.0±1.1). After 12 endermology sessions, patients with indurations reported having experienced a reduction in size (10 patients [90.9%]; mean diameter, 0.1±0.05 cm; P<0.001) and number of indurations (nine patients [81.8%]; mean number, 2.3±1.1; P<0.005). These indurations completely disappeared from arms, thighs, buttocks, and abdomen in six (75.0%), six (75.0%), two (50.0%), and three (42.9%) patients, respectively. Three of these patients (27.3%) recovered from all indurations. Although panniculitis/lipoatrophy did not completely disappear, all patients reported improvements. Most patients with indurations (63.6%) felt very satisfied and considered endermology very useful for reducing indurations. All patients with panniculitis/lipoatrophy were satisfied and considered to be endermology useful in improving it. In addition, endermology enabled glatiramer acetate tolerance to be improved in most patients (60.0%).
  
  
  CONCLUSIONS
  Endermology may contribute to improving indurations and panniculitis/ lipoatrophy at the site of subcutaneous injection of glatiramer acetate in patients with MS, enabling areas of injection to recover, and treatment tolerance to increase.
authors.affiliation: Neurology Department, Hospital de Cabueñes, Gijón, Spain.
authors.forename: Delia
authors.initials: D
authors.lastname: Rubio Fernández
authors.forename: Clara
authors.initials: C
authors.lastname: Rodríguez Del Canto
authors.forename: Virginia
authors.initials: V
authors.lastname: Marcos Galán
authors.forename: Natalia
authors.initials: N
authors.lastname: Falcón
authors.forename: Héctor
authors.initials: H
authors.lastname: Edreira
authors.forename: Lidia
authors.initials: L
authors.lastname: Sevane Fernández
authors.forename: Pablo
authors.initials: P
authors.lastname: Francoli Martínez
authors.forename: Rainel
authors.initials: R
authors.lastname: Sánchez-De la Rosa
mesh_terms: D000328:Adult; D005260:Female; D000068717:Glatiramer Acetate; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D007279:Injections, Subcutaneous / Q000009:adverse effects; D008060:Lipodystrophy / Q000209:etiology / Q000628:therapy*; D008405:Massage / Q000379:methods*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy; D015434:Panniculitis / Q000209:etiology / Q000628:therapy*; D010455:Peptides / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D010455:Peptides; D000068717:Glatiramer Acetate