Well, the clinical trials on humans has begun so we will find out won't we?
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Kevin - The management - keratin.com

True... They should have the results by the summer, let's see what happens.

I'm curious, how much money does a firm have to spend in order to approve a new product like this one? How much do you think they have to spend in order to reach a stage where they know for sure if it works or not?

I understand big pharmas can run the risk of having unsuccessful attempts, but can a small biotech run that risk too?

Last edited by fonzie on Sun Jun 08, 2003 4:20 pm; edited 1 time in total

Kevin, if all the available topical immunosupressants and immunomodulators reached the hair follicle, which one do you think would be the most effective in treating AA?

topicals

Our experience with topical steroids has been the same as with oral steroids therefore it makes no sense to me to use a topical steroid that penetrates well because the results will be temporary. Clobetasol in Zinc Cap worked wonders for my daughter, she acheived full regrowth, quickly. BUT should you miss a day, or should you not be able to get quite as much through to the scalp, the hair will fall out, just as if you stopped taking an oral steroid. In our case the hair fell out at an alarming rate and no amout of topical would stop it. Maybe the body just gets used to it and so it no longer works after a while. Either way, this wouldn't seem like a good long term treatment to me, perhaps for people that only get a spot here and there it would be great. Otherwise it's just cruel. If they could make a topical penetrate better then I would hope that it wouldn't have the same systemic effects as steroids do.

Hi Kristin,

What you say is quite true, but steroids in topical liposomes could potentially substitute steroid shots... and that would be great for many patchy AA sufferers - no pain, lower cost, fewer systemic absorption (I hope).

Anyway, I was also thinking of other immunomodulators that could perhaps be used in the long term without significant side-effects like cyclosporin, tacrolimus, pimecrolimus, rapamycin or maybe even calcipotriol.

The systemic impact of topical liposomes I think is still pretty much unknown, but it shouldn't be very harsh. The vectron clinical trials will probably give us a clue to that.

Kevin, I had an appointment with a dermatologist today, and we were discussing this issue of skin penetration in AA.

She didn't seem to understand much about liposomes, but she suggested I'd go to a * and buy some kind of steroid pills (deflazacort I think) and get the * to break it into powder. Then I'd bring the powder to her office and she would use it to perform something called hydro iontophoresis (transdermal). Do you know what that is??

Found this:

http://www.empi.ca/b/b4.htm

quote:

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What is Iontophoresis?
Iontophoresis is an alternative drug delivery system. By applying a low-level electrical current to a similarly charged drug solution, iontophoresis repels the drug ions through the skin to the underlying tissue. In contrast to passive transdermal patch drug delivery, iontophoresis is an active (electrically driven) method that allows the delivery of water-soluble ionic drugs that are not effectively absorbed through the skin.

Iontophoresis is widely used for the delivery of corticosteroids in treating acute or sub-acute inflammatory conditions and acute flare-ups of chronic inflammatory conditions.

Characteristics of drugs that could potentially be delivered using iontophoresis:

Used for localized conditions
Water-soluble
Positively or negatively charged
Relatively small molecular size
Advantages of iontophoresis:

The risk of infection is reduced because it is non-invasive.
Drug solutions are delivered directly to the treatment site without the disadvantages of injections or orally administered drugs.
It provides a relatively pain-free option for patients who are reluctant or unable to receive injections.
It minimizes the potential for further tissue trauma that can occur with increased pressure from a fluid bolus injection.
Iontophoresis requires medical knowledge and skill. It can only be performed by a physician or on the order of a physician by a trained health professional.

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Yeah iontophoresis is another option to increase skin penetration. The problem being it has to be carried out at the clinic wheras with a liposome formulation you could potentially let the patient take the ointment home and apply it there.

Liposomes are still fairly new to the clinical world although they have been discussed in academia for some years. So far I don't know of any drugs available at the average * in liposomal formulations. So not really surprising the doc did not know much about them. Liposomes are still largely experimental.
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Kevin - The management - keratin.com

I'm lucky because the clinic where the derm works is just 2 blocks away from home, so I can easily go there and get it done.

She seems to be confident in the PUVA approach and advised me to try it for a couple of months. I'm just worried because I read PUVA can increase melanoma risk... or is that just for long-term PUVA?

She also talked about DPCP, but said its very hard to find it here in Portugal. Could I order from your clinic? Or from your clinic's supplier?

i was wondering the same thing could i buy the dncp from you kevin??