Hirsutism Treatment - Growth Inhibitors

Drugs that block enzymes in the hair itself that inhibit growth

Ornithine decarboxylase blocker: EFLORNITHINE (VANIQA®)

VANIQA® - this is a new drug that blocks an enzyme that is required for the growth of hair.

Approved use

Used for the treatment of female facial hair. The history of this drug is interesting in that it was first used for African sleeping sickness.It no longer is the drug of choice for this use.

How does Vaniqa® work?

It inhibits the enzyme ornithine decarboxylase(ODC) which is a required enzyme for hair growth. It reduce the rate of hair growth . It does not remove hair but blocks the production of hair shaft protein as well as stopping the growth of the hair matrix cells after they have been stimulated by androgens blocks the conversion of the protein Ornithine to Putrecine.

The drug is applied as a cream to the skin. Less than 1% is absorbed through the skin and this is excreted unchanged by the kidneys. It does not accumulate in the plasma.

This drug is not genotoxic, not carcinogenic, no photo carcinogenic and not teratogenic.

How is the drug used?

Apply twice a day to the area to be treated. It can be combined with other treatments to enhance the effectiveness of both treatment modalities.

Combination therapy with laser - 2 studies

1. Reported at American society of Laser Medicine and Surgery Abstracts 2003 105:32.
   Hair removal with combined Alexandrite laser and Vaniqa was superior to removal of unwanted facial hair with laser alone
2. Reported at 61st annual Meeting of the Academy of Dermatology San Francisco 2003(Poster 649)
   "Concomitant use of Vaniqa and laser(1064nm Nd-YAG and a 755nm Alexandrite laser) showed synergistic effect with greater benefit, both with r respect to onset and degree of removal, for the initial period(22weeks) of hair removal therapy. Patient satisfaction clearly supported the use of combination therapy"

Studies with Eflornithine

1. Two Efficacy and safety phase 111 trial of Vaniqa in the treatment of women with hirsutism
2. reported in Annual meeting of the American Academy of Dermatology 2000. Vaniqa shown to be superior to placebo at 24 weeks in 176 women on the active drug compared with 92 on placebo The other study showed 73% had improvement compared with 44% in the placebo group. 67% of women had shown improvement compared with 39% in the vehicle only group.
   The longer the study went on the better the results. The benefit only lasted as long as the treatment was used. There was an improvement in the quality of life measurements
   The adverse events were mild and transient
3. Study on long-term(12 month) safety in women with Vaniqa with excessive facial hair
   No serious side effects were seen. 1% discontinued because of adverse events. 42% experienced mild side effects
   
   Most frequent side effects reported

• Dry skin 7.4%
• Alopecia 6.5%
• Acne 6.9%
• Headache 6.0%
• Pruritus 5.1%
• Burning skin 4.6%
• Stinging skin 4.2%
• Ingrown hair 3.7%
• Rash 3.2%
• Tingling skin 3.2%
• Erythema 2.3%
• Edema 1.4%

FAQ

Is Vaniqa a prescription only drug?
YES

Can Vaniqa be used in all groups' women regardless of race or colour?
YES

Does Vaniqa interact with other topical medications?
No interactions known

Can Vaniqa be used with various hair removal methods?
YES

Can Vaniqa be used whilst pregnant or during breast feeding?
No evidence to suggest a problem but it is best to avoid in both situations.

How much Vaniqa should be used?
A pea sized amount twice a day. Not more than30g per month

Can Vaniqa be used in other parts of the body?
At this time it is indicated only for unwanted hair on the face