Repost: preventing angiogenesis

[Guest guest]

Tom requested that I post:

-=-=-

just a thought, but the article is from a Galderma site, the maker of

Metrogel. In other words, Tretinoin (retin-a et al) is a (potential)

competitor.

The author (who paid him? what is his affiliation with galderma if

any?) cherry-picked a few negative snippets, from various studies

without context or opposing viewpoints. Much of the positive studies

came later than this article if I recall.

-=-=-

Tom, the article is an editorial originally published in the Archives

of Dermatology. That means the copyright belongs to the journal, and

any deals made to post on Galderma's Web site would be with the

journal, not the author.

Your criticism would be valid if he was writing a review article on

rosacea. But as an editorial, he's allowed to select resources that

support his thesis on the pathophysiology and treatment of rosacea

without being balanced.

Is there a more recent article that addresses Wilkin's concern over

the angiogenetic potential of tretinoin? I recall someone here posted

about seeing a poster glorifying new vessel growth to geriatricians,

so it sounds like at least one company is proporting the same thing

as Wilkin's editorial. He's regarded as an expert on rosacea.

It's a critical concern, obviously. But if true, then why would ANY

rosacean improve on tretinoin? Does angiogenesis occur in just select

patients? Are the anti-inflammatory features more important to some

rosaceans than pro-vascular growth? The study describing tretinoin's

inhibition of VEGF seems like the opposite of Kligman's 1993 study,

though Kligman's observation of angiogenesis may not be on the face.

But wasn't Kligman supportive of using tretinoin on rosacea, or am I

confused? (or both <g>)

Before taking sides on such a controversal therapy, I need to better

understand how tretinoin impacts on rosacean skin, and see better

studies documenting safety and efficacy.

Marjorie

Marjorie Lazoff, MD

[Guest guest]

Tom requested that I post:

-=-=-

just a thought, but the article is from a Galderma site, the maker of

Metrogel. In other words, Tretinoin (retin-a et al) is a (potential)

competitor.

The author (who paid him? what is his affiliation with galderma if

any?) cherry-picked a few negative snippets, from various studies

without context or opposing viewpoints. Much of the positive studies

came later than this article if I recall.

-=-=-

Tom, the article is an editorial originally published in the Archives

of Dermatology. That means the copyright belongs to the journal, and

any deals made to post on Galderma's Web site would be with the

journal, not the author.

Your criticism would be valid if he was writing a review article on

rosacea. But as an editorial, he's allowed to select resources that

support his thesis on the pathophysiology and treatment of rosacea

without being balanced.

Is there a more recent article that addresses Wilkin's concern over

the angiogenetic potential of tretinoin? I recall someone here posted

about seeing a poster glorifying new vessel growth to geriatricians,

so it sounds like at least one company is proporting the same thing

as Wilkin's editorial. He's regarded as an expert on rosacea.

It's a critical concern, obviously. But if true, then why would ANY

rosacean improve on tretinoin? Does angiogenesis occur in just select

patients? Are the anti-inflammatory features more important to some

rosaceans than pro-vascular growth? The study describing tretinoin's

inhibition of VEGF seems like the opposite of Kligman's 1993 study,

though Kligman's observation of angiogenesis may not be on the face.

But wasn't Kligman supportive of using tretinoin on rosacea, or am I

confused? (or both <g>)

Before taking sides on such a controversal therapy, I need to better

understand how tretinoin impacts on rosacean skin, and see better

studies documenting safety and efficacy.

Marjorie

Marjorie Lazoff, MD