title: Prevention and Management of Injection-Related Adverse Effects in Facial Aesthetics: Considerations for ATX-101 (Deoxycholic Acid Injection) Treatment.
abstract: ATX-101 (deoxycholic acid injection; Kythera Biopharmaceuticals, Inc. [an affiliate of Allergan plc, Dublin, Ireland]) was approved in 2015 in the United States (Kybella) and Canada (Belkyra) for submental fat reduction. As expected, injection-site reactions such as pain, swelling, and bruising, which were mostly mild or moderate and transient, were common adverse events (AEs) reported in clinical trials. An exploratory Phase 3b study investigating interventions for management of injection-site AEs associated with ATX-101 treatment was recently completed. Based on its results, literature review, and our clinical experiences, we have put forward considerations for management of AEs associated with ATX-101 treatment in clinical practice. Pretreatment with oral ibuprofen and/or acetaminophen an hour before treatment and preinjection with epinephrine-containing buffered lidocaine 15 minutes before treatment can help with management of pain and bruising. Cold application to the treated area before and immediately after the procedure may help to reduce pain (if local anesthetic preinjection is not performed) and swelling. Discontinuing medications/supplements that result in increased anticoagulant or antiplatelet activity 7 to 10 days before ATX-101 treatment, when possible, can reduce the risk of bruising. In summary, injection-site AEs associated with ATX-101 treatment can be effectively managed with commonly used interventions.
authors: *Private Practice, Boca Raton, Florida; †Evidence Scientific Solutions, Philadelphia, Pennsylvania; ‡Department of Dermatology, University of California Los Angeles and Private Practice (Skin Care and Laser Physicians of Beverly Hills), Los Angeles, California.
authors: Steven
authors: S
authors: Fagien
authors: Patricia
authors: P
authors: McChesney
authors: Meenakshi
authors: M
authors: Subramanian
authors: Derek H
authors: DH
authors: Jones
mesh_terms: D002986:Clinical Trials as Topic; D003288:Contusions / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D003357:Cosmetic Techniques / Q000009:adverse effects*; D003840:Deoxycholic Acid / Q000008:administration & dosage / Q000009:adverse effects*; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D004487:Edema / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007279:Injections, Subcutaneous / Q000009:adverse effects*; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control / Q000628:therapy; D050151:Subcutaneous Fat / Q000187:drug effects*
chemical_list: C000599116:ATX-101 compound; D003879:Dermatologic Agents; D003840:Deoxycholic Acid