Verteporfin: Difference between revisions
→Potential against scarring: trim to fact; the anti-scarring indication is conjecture from primary research |
I added a new field of study for the drug Verteporfin that involves androgenetic alopecia and hair transplantation surgery. In particular, I cited studies by 2 hair transplantation surgeons that examined the drug's potential in regenerating hair follicles that had been extracted and reducing scar tissue induced by said surgery. I note that the research is off-label in the heading, and that further research on the topic is on the way. Tags: Reverted Visual edit |
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== Off-label use in retinopathy == |
== Off-label use in retinopathy == |
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Verteporfin may be [[Off-label use|used off-label]] for treating a form of retinopathy.<ref name=offlab/><ref name=shortage/> |
Verteporfin may be [[Off-label use|used off-label]] for treating a form of retinopathy.<ref name=offlab/><ref name=shortage/> |
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== Off-label use in hair loss == |
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Verteporfin has recently been examined for the treatment of [[Pattern hair loss|androgenetic alopecia.]] <ref>{{Cite web |title=Donor Healing Study With Verteporfin By Dr. Barghouthi – Follicle Thought |url=https://folliclethought.com/donor-healing-study-with-verteporfin-by-dr-barghouthi/ |access-date=2024-01-13 |language=en-US}}</ref> Due to Verteporfin's anti-[[Fibrosis|fibrotic]] effects and its use in wound healing in animal models <ref>{{Cite journal |last=Januszyk |first=Michael |last2=Talbott |first2=Heather E. |last3=Griffin |first3=Michelle |last4=Guardino |first4=Nicholas |last5=Spielman |first5=Amanda |last6=Guo |first6=Jason L. |last7=Mascharak |first7=Shamik |last8=Wan |first8=Derrick C. |last9=Longaker |first9=Michael T. |date=2022-11 |title=Inhibition of Yes-Associated Protein Promotes Skin Wound Regeneration in Large Animals |url=https://journals.lww.com/journalacs/citation/2022/11001/inhibition_of_yes_associated_protein_promotes_skin.380.aspx |journal=Journal of the American College of Surgeons |language=en-US |volume=235 |issue=5 |pages=S196 |doi=10.1097/01.XCS.0000894508.92389.a2 |issn=1879-1190}}</ref>, it has been proposed as a possible pathway to solve pattern hair loss by providing an increased amount of donor hairs in [[Hair transplantation|hair transplants]]. Through this proposed model, verteporfin would inhibit a pro-fibrotic protein known as YAP (Yes Associated Protein), which would then force the body to activate healing through regeneration, which would replace the extracted hair follicles and tissue with new hair, skin, and sweat glands, along with other parts of healthy skin, essentially regenerating the donor supply of hair follicles. This would then imply that an unlimited amount of hair follicles could be regenerated and then transplanted into balding regions. This particular model of hair recovery is looked at because of its potential to fully restore the hair density or even improve hair density in hair transplant patients who would otherwise lack the sufficient donor hair to cosmetically restore their hairlines fully. This would then imply that even a patient diagnosed as a [[Hamilton–Norwood scale|Norwood]] class 7 could potentially recover completely from a cosmetic point of view through hair transplantation, providing further enhancement to the practice of hair restoration surgery. |
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In a 2022 study <ref>{{Cite web |title=Donor Healing Study With Verteporfin By Dr. Barghouthi – Follicle Thought |url=https://folliclethought.com/donor-healing-study-with-verteporfin-by-dr-barghouthi/ |access-date=2024-01-13 |language=en-US}}</ref> by Dr. Taleb Bargouthi, a hair transplant surgeon from Jordan, subjects had an equal amount of hairs extracted from their donor region in set locations, which were marked as test and control groups, and were given varying doses of verteporfin, those being 0.24 mg, 0.32 mg, and 0.4 mg. There were also areas that were left untreated as a control group, in order to compare both results. Ultimately, the results were promising, displaying a notable difference in skin texture and hair counts in treated regions as opposed to untreated ones. The study also suggested that the nature of the results were [[Dose–response relationship|dose-dependent]]. |
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A further study from 2023 <ref>{{Cite web |title=Verteporfin Hair Transplant Surgery Trial With Dr. Bloxham – Follicle Thought |url=https://folliclethought.com/verteporfin-hair-transplant-surgery-trial-with-dr-bloxham/ |access-date=2024-01-13 |language=en-US}}</ref> by Dr. Blake Bloxham from Feller and Bloxham Medical studied the use of verteporfin in hair transplantation and yielded similar results. In particular, Dr. Bloxham suggested that treated regions presented lower levels of [[Scar|scar tissue]] and higher levels of hair follicles when compared to control groups. While this particular research is not completely finished, Dr. Bloxham has expressed positive feelings and hopes to continue research on the topic. |
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== References == |
== References == |
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Revision as of 21:06, 13 January 2024
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| Clinical data | |
|---|---|
| Trade names | Visudyne |
| AHFS/Drugs.com | Monograph |
| MedlinePlus | a607060 |
| License data | |
| Routes of administration | Intravenous |
| ATC code | |
| Legal status | |
| Legal status |
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| Identifiers | |
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| CAS Number | |
| PubChem CID | |
| DrugBank | |
| ChemSpider | |
| UNII | |
| KEGG | |
| ChEBI | |
| ChEMBL | |
| CompTox Dashboard (EPA) | |
| Chemical and physical data | |
| Formula | C41H42N4O8 |
| Molar mass | 718.807 g·mol−1 |
| 3D model (JSmol) | |
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  (what is this?) (verify) | |
Verteporfin (trade name Visudyne), a benzoporphyrin derivative, is a medication used as a photosensitizer for photodynamic therapy to eliminate the abnormal blood vessels in the eye associated with conditions such as the wet form of macular degeneration. Verteporfin accumulates in these abnormal blood vessels and, when stimulated by nonthermal red light with a wavelength of 689 nm[1] in the presence of oxygen, produces highly reactive short-lived singlet oxygen and other reactive oxygen radicals, resulting in local damage to the endothelium and blockage of the vessels.[2][3]
Verteporfin is also used off-label for the treatment of central serous retinopathy.[4]
Administration
Verteporfin is usually injected intravenously into the largest arm vein.[5] It is injected at a dose of 6 mg/m2 and light-activated.[5] It is usually given 15 minutes before laser treatment.[2] This dose can be repeated 4 times per year.[5]
Contraindications
Side effects
Most common side effects are blurred vision, headache, and local effects at the injection site. Also, photosensitivity; it is strictly advised to avoid exposure to sunlight and unscreened lighting until 48 hours after verteporfin administration.[2]
Dogs and rats have been treated with inactivated daily doses 32–70 times higher than the dose advised for humans.[5] The 4 weeks of treatment resulted in mild extravascular hemolysis and hematopoiesis in the animals.[5]
Light-activated cytotoxicity
Used by itself, the clinical recommended dose for verteporfin is not cytotoxic to human tissue.[6] Though under light activation, in the presence of oxygen, it can form cytotoxic agents inside the tissue.[6] The agents form when the porphyrin absorbs enough light to generate a reactive but short-lived singlet oxygen.[6] The brief singlet oxygen can micro damage biological structures, leading to a local vascular occlusion.[6]
Interactions
Verteporfin is known to interact with the herbal remedy feverfew (Tanacetum parthenium), the latter of which seems to act as an antagonist to verteporfin for unknown reasons. Taking the two substances simultaneously is inadvisable.[7]
Verteporfin does not appear to be metabolized by Cytochrome P450 enzymes, therefore not affecting Cytochrome P450 metabolism of other drugs.[8]
Shortages
In May 2020, a low manufacturing capacity caused disruption.[9] This affected the usage of verteporfin among providers and patients in Europe.[9] The EMA expected normal manufacturing to return by the first quarter 2022.[9]
Off-label use in retinopathy
Verteporfin may be used off-label for treating a form of retinopathy.[4][9]
Off-label use in hair loss
Verteporfin has recently been examined for the treatment of androgenetic alopecia. [10] Due to Verteporfin's anti-fibrotic effects and its use in wound healing in animal models [11], it has been proposed as a possible pathway to solve pattern hair loss by providing an increased amount of donor hairs in hair transplants. Through this proposed model, verteporfin would inhibit a pro-fibrotic protein known as YAP (Yes Associated Protein), which would then force the body to activate healing through regeneration, which would replace the extracted hair follicles and tissue with new hair, skin, and sweat glands, along with other parts of healthy skin, essentially regenerating the donor supply of hair follicles. This would then imply that an unlimited amount of hair follicles could be regenerated and then transplanted into balding regions. This particular model of hair recovery is looked at because of its potential to fully restore the hair density or even improve hair density in hair transplant patients who would otherwise lack the sufficient donor hair to cosmetically restore their hairlines fully. This would then imply that even a patient diagnosed as a Norwood class 7 could potentially recover completely from a cosmetic point of view through hair transplantation, providing further enhancement to the practice of hair restoration surgery.
In a 2022 study [12] by Dr. Taleb Bargouthi, a hair transplant surgeon from Jordan, subjects had an equal amount of hairs extracted from their donor region in set locations, which were marked as test and control groups, and were given varying doses of verteporfin, those being 0.24 mg, 0.32 mg, and 0.4 mg. There were also areas that were left untreated as a control group, in order to compare both results. Ultimately, the results were promising, displaying a notable difference in skin texture and hair counts in treated regions as opposed to untreated ones. The study also suggested that the nature of the results were dose-dependent.
A further study from 2023 [13] by Dr. Blake Bloxham from Feller and Bloxham Medical studied the use of verteporfin in hair transplantation and yielded similar results. In particular, Dr. Bloxham suggested that treated regions presented lower levels of scar tissue and higher levels of hair follicles when compared to control groups. While this particular research is not completely finished, Dr. Bloxham has expressed positive feelings and hopes to continue research on the topic.
References
- ^ "Visudyne package insert" (PDF).
- ^ a b c d Verteporfin Monograph
- ^ Scott LJ, Goa KL (February 2000). "Verteporfin". Drugs & Aging. 16 (2): 139–46, discussion 147–8. doi:10.2165/00002512-200016020-00005. PMID 10755329. S2CID 260491296.
- ^ a b Karim SP, Adelman RA (2013). "Profile of verteporfin and its potential for the treatment of central serous chorioretinopathy". Clinical Ophthalmology. 7: 1867–75. doi:10.2147/OPTH.S32177. PMC 3788817. PMID 24092965.
- ^ a b c d e Mohede, Daan C.J. (28 September 2018), "Verteporfin as a Medical Treatment in Peyronie's Disease", Sex Med, 6 (4): 302–308, doi:10.1016/j.esxm.2018.08.002, PMC 6302152, PMID 30274909
- ^ a b c d "SUMMARY OF PRODUCT CHARACTERISTICS" (PDF). ema.europa.eu. 13 December 2023. Retrieved 13 December 2023.
By itself, the clinically recommended dose of verteporfin is not cytotoxic. It produces cytotoxic agents only when activated by light in the presence of oxygen. When energy absorbed by the porphyrin is transferred to oxygen, highly reactive short-lived singlet oxygen is generated. Singlet oxygen causes damage to biological stmctures within the diffusion range, leading to local vascular occlusion, cell damage and, under certain conditions, cell death.
- ^ "Feverfew and Verteporfin Interactions". Drugs.com. Retrieved 14 April 2015.
- ^ "Visudyne (verteporfin for injection) prescribing information" (PDF). FDA. Retrieved 12 April 2021.
- ^ a b c d EMA (5 November 2021). "Shortage of Visudyne (verteporfin)" (PDF). ema.europa.eu. Retrieved 1 February 2022.
- ^ "Donor Healing Study With Verteporfin By Dr. Barghouthi – Follicle Thought". Retrieved 2024-01-13.
- ^ Januszyk, Michael; Talbott, Heather E.; Griffin, Michelle; Guardino, Nicholas; Spielman, Amanda; Guo, Jason L.; Mascharak, Shamik; Wan, Derrick C.; Longaker, Michael T. (2022-11). "Inhibition of Yes-Associated Protein Promotes Skin Wound Regeneration in Large Animals". Journal of the American College of Surgeons. 235 (5): S196. doi:10.1097/01.XCS.0000894508.92389.a2. ISSN 1879-1190.
{{cite journal}}: Check date values in:|date=(help) - ^ "Donor Healing Study With Verteporfin By Dr. Barghouthi – Follicle Thought". Retrieved 2024-01-13.
- ^ "Verteporfin Hair Transplant Surgery Trial With Dr. Bloxham – Follicle Thought". Retrieved 2024-01-13.
External links
- "Visudyne". Novartis.