Lipoatrophy in Canadian Multiple Sclerosis Patients Receiving Glatiramer Acetate

Glatiramer acetate (GA) is indicated for use in patients with relapsing-remitting multiple sclerosis (RRMS). One of the side effects of GA is lipoatrophy, a localized loss of subcutaneous fat around the injection site. A Canadian postmarketing observational study on MS patients receiving GA was designed to provide further insight on lipoatrophy and to assess the utility of using digital images of lipoatrophic lesions to confirm diagnosis and define severity. From a Teva Canada Innovation–sponsored MS support program, with a total population size at the time of the study of 5770 patients receiving GA, patients with self-reported lipoatrophy were identified by a nurse who took photographs of possible lipoatrophic lesions and recorded patient demographic and clinical data during a home visit. Photographs were then assessed by an immunodermatologist (AAG) to confirm lipoatrophy and grade severity. The patients with self-reported lipoatrophy who consented to participate in the study (N = 206) had a mean age of 47.2 years; 98.1% were female, and 54.4% had been taking GA for more than 5 years. Clinical images from 192 patients were available for review. Lipoatrophy was confirmed in 85% of patients. Lesions occurred at all injection sites with equal frequency, with no significant differences in severity. This study demonstrates that most GA-treated patients with lipoat-rophy can correctly diagnose the condition and that digital photographs can play a role in confirming the presence of lipoatrophy, allowing nurses to initiate timely and appropriate interventions.