Physician Clinical Exchange > "Journal Club" - Users Group
Aesthetic Surg J 2008; 28: 17-23
American Journal for Dermatologic Surgery 2007; 33: S128-S135
Plastic Reconstructive Surgery. 121:289, 2008
You can get all of these Articles from your Allergan Rep is you don't have them.
This is what they say. Please read the actual articles before you promise 1 year duration from Juvederm. If you don't, you will be over promising and under delivering. This will result in unhappy patients.
1. Juvederm is compared to Collagen. Of course it is better, collagen only lasts 2 months.
2. The artilcles say that you need TWO SYRINGES to correct Nasolabial Folds. This is because they ONLY give you 0.8 cc per syringe. What does two syringes cost you and what do you charge for two syringes?
3. Correction is based on a 5 point grading system. "Clinically Significant mean wrinkle reduction at 9 months and 1 year is achieved if there is a ONE POINT IMPROVEMENT at 9 months and 1 year. In other words, 80% of the effect is gone, but Allergan claims that there is still a "clinically significant" improvement and they use this to tell you that Juvederm lasts for over 1 year. Read the article. Would your patients be happy?
My assessment. Figures lie and liars figure. My patients are not happy with a 20% improvement and they won't be happy when 80% of the effect has gone away. I am looking for a patient satisfaction study from Allergan and I am looking forward to reading the "fine print". I am very dissappointed that Allergan is cheapening the phrase "clinically significant improvement". Clinically significant improvement means that patients are HAPPY and referring friends and relatives!
I would love to know how long Juvederm really lasts and how long Perlane and Radiesse last. Does anyone know? Are there any studies? I would say that in my book, clinically significant means at least a 3 out of 5. What say you?
MDR
I agree that you need to read between the lines as well as the fine print. If you look at Radiesse one of the studies they use was based on a biopsy that showed the calcium hydroxylapetite was still present on biopsy but does not talk about the cosmetic appearance.
Another thing we need to always look at is, who sponsored the study. I also like to look at who did the study. Some of these "authors" in the cosmetic surgery field seem to have sold their souls.
LH
Laser Hair Removal with an 800 nm Diode Laser - A retrospective Study on 1000 Women with Skin Types II - VI.
Atif Kazmi, MD
Copyright 2002, the Lumenis Group
Pakistan Women
This study, no published or peer reviewed, showed that LightSheer Laser can be used safely and effectively in Pakistani Women (and therefore Indian Women).
Contact your Lumenis Rep for a copy of this article.
I have had the LightSheer for 6 months now and so far, so good. I really like it. Big improvement over Cutera.
JEE
Juvederm lasts over 1 year (this is not true!)
3. Correction is based on a 5 point grading system. "Clinically Significant mean wrinkle reduction at 9 months and 1 year is achieved if there is a ONE POINT IMPROVEMENT at 9 months and 1 year. In other words, 80% of the effect is gone, but Allergan claims that there is still a "clinically significant" improvement and they use this to tell you that Juvederm lasts for over 1 year. Read the article. Would your patients be happy?
MDR
In our Journal Club we will read articles and write short summaries. We can then comment on these Articles and these Summaries.
The first Article we will review is the Article that Allergan is using to "claim" that Juvederm UltraPlus lasts for 1 year [Juvederm Injectable Gel: A Multicneter, Double-Blind, Randomized Study of Safety and Effectiveness, Aesthetic Surgery Journal, Volume 28, Number 1, Jan/Feb 2008, 17-23].
You might be suprised what you find when you read the actual article and you learn how they define "clinically significant mean wrinkle correction" !!!
You will be even more suprised when you re-look at Allergan's promotional material, and you see how they have "spun" this information to mislead providers and patients.
The purpose of this "Journal Club" User Group is to find and expose "The Truth".
Hopefully we can all work together to read the actual articles and review the basic material so we are not at the mercy of the "spin master marketing guys" who feed us half-truths and exaggerations. Do I seem skeptical? You bet I am. If you are not skeptical of everything that comes from the Laser and Injectable Companies, you have not been in the business very long.