Phosphatidylcholine and Sodium Deoxycholate in the Treatment of Localized Fat: A Double‐Blind, Randomized Study

• Published in: Dermatologic surgery Vol. 34; no. 1; pp. 60 - 66
• Main Authors: SALTI, GIOVANNI, GHERSETICH, ILARIA, TANTUSSI, FRANCA, BOVANI, BRUNO, LOTTI, TORELLO
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-01-2008; by the American Society for Dermatologic Surgery, Inc
• Subjects: Adipose Tissue - diagnostic imaging; Adipose Tissue - drug effects; Adult; Cosmetic Techniques; Deoxycholic Acid - pharmacology; Dermatologic Agents - pharmacology; Double-Blind Method; Female; Humans; Injections, Subcutaneous; Middle Aged; Phosphatidylcholines - pharmacology; Ultrasonography
• ISSN: 1076-0512; 1524-4725
• DOI: 10.1111/j.1524-4725.2007.34009.x

BACKGROUND
Recent articles have introduced the novel concept of chemical lipolysis through local injections. Phosphatidylcholine is the active drug in the commercial preparation used for this purpose, but some studies have suggested that sodium deoxycholate, an excipient of the preparation, could be the real active substance.
AIM
We decided to investigate whether phosphatidylcholine and sodium deoxycholate have any clinical efficacy in chemical lipolysis and their respective roles. We also studied the safety and side effects of the treatments.
MATERIALS AND METHODS
Thirty‐seven consecutive female patients were studied for the treatment of localized fat in gynoid lipodystrophy. Each patient received injections of a phosphatidylcholine/sodium deoxycholate preparation on one side and sodium deoxycholate on the contralateral side, each single patient being herself the control. Four treatments were carried out every 8 weeks in a double‐blind, randomized fashion. Metric circumferential evaluations and photographic and ultrasonographic measurements throughout the study allowed for final judgment. A statistical evaluation concluded our study.
RESULTS
An overall reduction of local fat was obtained in 91.9% of the patients without statistically significant differences between the treated sides. Reduction values on the phosphatidylcholine/sodium deoxycholate–treated sides are in the order of 6.46% metrically and 36.87% ultrasonographically, whereas on the deoxycholate‐treated sides they are in the order of 6.77% metrically and 36.06% ultrasonographically. Both treatments, at the dose used in the study, proved safe in the short term. The most common side effects were local and few, but were more pronounced on the deoxycholate‐treated sides. No laboratory test was carried out.
CONCLUSION
Both treatments have shown moderate and equivalent efficacy in treating localized fat, with sodium deoxycholate having a slower postoperative resolution, suggesting that sodium deoxycholate could be sufficient by itself to determine fat cell destruction and that phosphatidylcholine could be useful for obtaining a later emulsification of the fat.