Adverse events and their management of patients with the use of deoxycholic acid for the treatment of submental fat: uma integrative review
DOI:
https://doi.org/10.33448/rsd-v12i5.41808Keywords:
Deoxycholic acid; Lipolysis; Adverse events; Adipose tissue; Subcutaneous fat.Abstract
The objective was to present scientific and clinical evidence of adverse events reported in patients using deoxycholic acid to reduce localized adiposity in the submental region, as well as to identify and report the management of these events. This study was conducted in the format of an integrative literature review that carried out a qualitative analysis of articles published in the last ten years (2013-2022). 116 findings were found by crossing the descriptors and after the identification and screening process, 5 scientific articles were selected to compose this research. When analyzing the selected articles, we can observe the presence of adverse events in most patients with the use of deoxycholic acid, being mainly related to the application procedure and reporting that these were mild to moderate, transient and resolved between treatments. However, there is one study that investigated the usefulness of topical/injectable anesthetics, oral analgesics and antihistamines, mechanical compression and cold therapy to improve patient comfort with respect to pain, swelling/edema and bruising after treatment with this substance. Researches like these need to be more evidenced, as it found that the occurrence of adverse events is related to the induced inflammatory process, but also to the ability to administer the substance, in addition to the deep knowledge of the anatomical region. There are common adverse events, but there are occurrences of serious events such as alopecia, nodules, necrosis and paresis of the mandibular marginal nerve. In view of this, the lack of specific safety and management protocols for treatment with this substance stands out.
References
Amore, R., Amuso, D., Leonardi, V., Leva, F., Sibaud, A. C., Guida, A., Costa, E., Terranova, F., Amodeo, V., & Gkritzalas, K. (2018). Evaluation of Safe and Effectiveness of an Injectable Solution Acid Deoxycholic Based for Reduction of Localized Adiposities. Plastic and reconstructive surgery. Global open, 6(6), e1794. https://doi.org/10.1097/GOX.0000000000001794.
ANVISA (2018). Resultado da consulta de parecer Público de Avaliação do Medicamento Belkyra. Agência Nacional de Vigilância Sanitária. https://consultas.anvisa.gov.br/#/pareceres/q/?nomeProduto=BELKYRA&substancia=269.
Ascher, B., Hoffmann, K., Walker, P., Lippert, S., Wollina, U., & Havlickova, B. (2014). Efficacy, patient-reported outcomes and safety profile of ATX-101 (deoxycholic acid), an injectable drug for the reduction of unwanted submental fat: results from a phase III, randomized, placebo-controlled study. Journal of the European Academy of Dermatology and Venereology: JEADV, 28(12), 1707–1715. https://doi.org/10.1111/jdv.12377.
Deeks, E. D. (2016). Deoxycholic Acid: A Review in Submental Fat Contouring. American journal of clinical dermatology, 17(6), 701–707. https://doi.org/10.1007/s40257-016-0231-3.
Dover, J. S., Kenkel, J. M., Carruthers, A., Lizzul, P. F., Gross, T. M., Subramanian, M., & Beddingfield, F. C., 3rd (2016). Management of Patient Experience With ATX-101 (Deoxycholic Acid Injection) for Reduction of Submental Fat. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al.], 42 Suppl 1, S288–S299. https://doi.org/10.1097/DSS.0000000000000908.
Fagien, S., McChesney, P., Subramanian, M., & Jones, D. H. (2016). Prevention and Management of Injection-Related Adverse Effects in Facial Aesthetics: Considerations for ATX-101 (Deoxycholic Acid Injection) Treatment. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al.], 42 Suppl 1, S300–S304. https://doi.org/10.1097/DSS.0000000000000898.
Ferreira, N. R., & Capobianco, M. P. (2016). Uso do ácido hialurônico na prevenção do envelhecimento facial. Revista Cientifica UNILAGO, 1(1), 1–10.
Geremia, K., Fontanive, T., & Mascarenhas, M. (2017). O efeito do desoxicolato de sódio no tratamento da gordura localizada: estudo de revisão. Ciência em Movimento, 19(38), 83–87.
Humphrey, S., Sykes, J., Kantor, J., Bertucci, V., Walker, P., Lee, D. R., Lizzul, P. F., Gross, T. M., & Beddingfield, F. C., 3rd (2016). ATX-101 for reduction of submental fat: A phase III randomized controlled trial. Journal of the American Academy of Dermatology, 75(4), 788–797.e7. https://doi.org/10.1016/j.jaad.2016.04.028.
Jones, D. H., Carruthers, J., Joseph, J. H., Callender, V. D., Walker, P., Lee, D. R., Subramanian, M., Lizzul, P. F., Gross, T. M., & Beddingfield, F. C., 3rd (2016). REFINE-1, a Multicenter, Randomized, Double-Blind, Placebo-Controlled, Phase 3 Trial With ATX-101, an Injectable Drug for Submental Fat Reduction. Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al.], 42(1), 38–49. https://doi.org/10.1097/DSS.0000000000000578.
Lemos, R. L., Silva, K. C. da, Morais, J. C. M. de, Silva, H. R., Ribeiro, R. de S., & Borges, R. M. (2021). Intradermoterapia no tratamento de gordura localizada: revisão integrativa/ Intradermotherapy in localized fat treatment: integrative review. Brazilian Journal of Development, 7(12), 111349–111360. https://doi.org/10.34117/bjdv7n12-085.
Lindgren, A. L., & Welsh, K. M. (2020). Inadvertent intra-arterial injection of deoxycholic acid: A case report and proposed protocol for treatment. Journal of cosmetic dermatology, 19(7), 1614–1618. https://doi.org/10.1111/jocd.13214.
Locks, F. (2018). POP-procedimento operacional padrão associado a anamnese para diferenciar pele íntegra de não íntegra na limpeza de pele: uma revisão. Estética e Bem Estar-Tubarão.
Mendes, K. D. S., Silveira, R. C. C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto-enfermagem, 17, 758–764.
Novais, M. D., & Souza, E. P. (2020). Utilização de Tratamentos Estéticos no Retardo do Envelhecimento Cutâneo: Revisão Integrativa / Use of Aesthetic Treatments to Delay Cutaneous Aging: Integrative Review. Revista de psicologia, 14(53), 950–961.
Park, S. H., Hyun, M. R., & Kim, S. W. (2019). Effect of a Formulation Containing Low-Dose Sodium Deoxycholate on Local Fat Reduction. Aesthetic plastic surgery, 43(6), 1657–1662. https://doi.org/10.1007/s00266-019-01514-2.
Pereira, I. M., Guedes, R., & Magalhães, M. de A. (2021). Particularidades do uso de injetáveis na redução de gordura localizada na face. Aesthetic Orofacial Science, 2(1), 49–60. https://doi.org/10.51670/ahof.v2i1.43.
Rzany, B., Griffiths, T., Walker, P., Lippert, S., McDiarmid, J., & Havlickova, B. (2014). Reduction of unwanted submental fat with ATX-101 (deoxycholic acid), an adipocytolytic injectable treatment: results from a phase III, randomized, placebo-controlled study. The British journal of dermatology, 170(2), 445–453. https://doi.org/10.1111/bjd.12695.
SBCP (2017). Sociedade Brasileira de Cirurgia Plástica. Estética: procura por procedimentos não cirúrgicos aumenta 390%. http://www2.cirurgiaplastica.org.br/2017/10/27/estetica-procura-por-procedimentos-nao-cirurgicos-aumenta-390/.
Shridharani S. M. (2017). Early Experience in 100 Consecutive Patients With Injection Adipocytolysis for Neck Contouring With ATX-101 (Deoxycholic Acid). Dermatologic surgery: official publication for American Society for Dermatologic Surgery [et al.], 43(7), 950–958. https://doi.org/10.1097/DSS.0000000000001133.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Priscylla Sacramento Flexa; Simone Andrade de Sousa; Natasha Cristina Silva da Silva
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
