Late last year Johnson & Johnson announced that it was discontinuing its collagen filler Evolence, and in January Allergan announced it would be discontinuing its collagen fillers at the end of the year. Allergan halted production of the products in 2009, but manufactured enough inventory to meet estimated market demand through the end of 2010, according to Kelly Lao, manager of corporate communications.

Patients who have received treatment with Evolence will continue to receive support regarding medical inquiries or reporting of adverse reactions.

As for Allergan’s collagen fillers, which includes CosmoPlast, CosmoDerm and bovine products Zyderm and Zyplast, Lao explains that “the discontinuation of the sale of our collagen products … is in response to declined market interest … since the introduction of hyaluronic acid dermal fillers like Juvéderm have become more popular.”

Seth L. Matarasso, M.D., clinical professor of dermatology at the  University of California School of Medicine, San Francisco, agrees with Lao’s assessment. “There is an overwhelming popularity of the new kid on the block: the hyaluronic acids. They have been embraced universally, and suddenly collagens aren’t as popular,” he says.

Hyaluronic acid products have several advantages, including:

• Longer-lasting results
• Appear to give a better fill
• Some contain lidocaine for less painful injections

Future improvements will allow hyaluronic acids to provide more volume and contour-changing ability and the ability to fill deeper lines, reports Dermatology Times.

Advancements in Dermatology and Skin Speaks Spa M.D. offer the following hyaluronic acids fillers: Juvéderm, Restylane, Radiesse, and Sculptra.

The full story is available online: “Dermatologists prepare for departure of collagen from U.S. market.”

Three injectables received FDA approval in February 2010 for lidocaine versions in the U.S.: Juvederm XC, Restylane-L, and Perlane-L. Lidocaine is a local anesthetic that is injected directly into the body and decreases pain by temporarily numbing the injection area, according to WebMD.

Dr. Michael H. Gold, a clinical assistant professor of dermatology at Vanderbilt University School of Medicine and School of Nursing, says that the products performed similarly to their lidocaine-free predecessors in terms of efficacy and safety.  “The incorporation of lidocaine has surely provided a higher comfort level for patients [in the clinical trials],” he adds.

Based on his clinical experience, Dr. Gold reports that when a patient undergoes an injection that includes even a small percentage of lidocaine that most patients say they barely feel the second injection. “To me that is the home run of lidocaine in these fillers,” he says.

In other injectable news, a filler that will soon reach the American market is Belotero Balance for nasolabial folds correction, which Dr. Gold says is awaiting FDA approval. Belotero Balance was first introduced in Germany in 2005.

Learn more about Juvederm and Restylane in the Twin Cities.

Read more about the latest in injectables online at Modern Medicine: “Fillers with lidocaine among latest injectable advancements.”

As with the original Juvederm, the product lasts up to 1 year from initial treatment. The addition of 0.3% lidocaine numbs the treatment area within seconds, potentially decreasing the need for additional anesthetic.

“Patients want a smooth and natural-looking result from a dermal filler treatment, but as a physician I am also interested in managing my patient’s discomfort during the injection. Before the introduction of Juvederm XC, it often took up to 30 minutes for an anesthetic block to take effect.” said Charles Boyd, MD, Boyd Cosmetic Surgical Institute and clinical investigator in a company news release. “[W]ith the new formulation, patients can receive the same smooth results as demonstrated with Juvederm but enjoy a more comfortable injection experience.”

FDA approval was based on data from a multicenter, double-blind, randomized clinical trial in which 72 patients received 1 of the 2 formulations in each nasolabial fold. Results showed that 93% of patients reported less procedural pain when treated with the lidocaine-containing dermal filler compared with the original version.

The safety profile was similar for both products, with temporary injection-site erythema, inflammation, pain/tenderness, firmness, lumps/bumps, and bruising most commonly reported. Most adverse events were mild to moderate in nature and of short duration (≤7 days).

With FDA approval, the lidocaine-containing dermal filler is available by prescription nationwide. As with the original formulation, it should only be administered by a trained medical professional.