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S k in D eep
Help nears for AIDS facial wasting
by Bob R oehr
om bination therapy had co n they believe it causes the wasting. But Conant
said it is unclear whether the syndrome is because
trolled Bradley Land’s HIV, hut it
of the disease itself and only becomes obvious
also drained the fat from his face,
over time, because of the drugs used in treating
marking it with the gaunt canyons
HIV or because of a combination of factors. His
th at belied his clinical good
experience
health. The social and psychological
effects using Sculptra in a research protocol
were devastating. “I was looking forward to sui during the past four months has led him to
believe, “It is safe and effective, and my patients
cide,” the Los Angeles resident said.
would benefit tremendously” from its availability.
T hen in 2003, six treatments with an exper
Sculptra is an injectable poly-L-lactic acid that
imental injection ameliorated the worst of his
has been available outside the United States since
facial wasting and people again began to look at
1999 under the trade name New-Fill. It has been
him “as a normal person” rather than as a skele
used on more than 150,000 patients in 33 coun
tal specter of death. Land is “proud and thankful
tries for cosmetic purposes such as filling wrinkles.
for my return to the human race.”
His story was just one of several moving testi
Facial wasting asscKiated with HIV is a much
more
severe problem, and significantly more of
monials that a Fcxxl and Drug Administration
the product has to be injected to achieve satisfac
advisory committee heard at a meeting March 25
outside Washington, D.C. The panel was consid tory results. The company that developed it was
ering expedited approval of what is now called
small and did not have the resources to put into
Sculptra for recoastructive purposes of lipoatro-
those clinical trials. As a result, most of the trials
phy associated with HIV infection and treatment.
have been investigator initiated, each slightly dif
ferent, with a small number of patients. That has
“Facial lipoatrophy has become the scarlet
made it difficult to evaluate and compare results.
letter of AIDS,” said veteran San Francisco
AIDS doc Marcus G m an t. “It is the thing that
A study of 50 patients in Paris used ultra
is bothering our patients the m ost...even doc sound to show a significant increase in total skin
tors wait to start their medication.” Nearly half thickness in the area treated with New-Fill. Pho
of all patients experience a degree of facial lipo tos also documented real improvement. But per
atrophy within three years of beginning therapy.
haps most important was the great satisfaction
Some patients have stopped therapy because
that most patients had with the procedure.
C
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Drs. Douglas Mest, Marcus Conant and Peter Engelhard testified at a Food and Drug
Administration advisory committee meeting March 25 outside Washington, D.C.
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