Response to "Injection Lipolysis With Phosphatidylcholine and Deoxycholate"

Abstract

In their Letter to the Editor, Dr Hasengschwandtner and Professor Gundermann of the Network Lipolysis raise some interesting points. The list of sequelae and complications provided by Network members is difficult to understand, as nods and pockets are not standard American terms. It should also be noted that the survey is retrospective and relies on the memory of the participants, which may not be entirely accurate. The authors did not describe the nature of the 33 complications that were not long term. Concerns are growing about the companies that distribute drugs not approved by the US Food and Drug Administration (FDA) or other national governing boards. The New England Compounding Center (NECC) made headlines in September 20121 when an outbreak of fungal meningitis was reported from contaminated epidural steroid injections. Reports of 48 deaths and more than 700 patients with infections made patients and physicians alike wary of compounding pharmacies. The NECC filed for Chapter 11 bankruptcy after more than 400 lawsuits were filed. In October 2012, in response to this situation, the US House of Representatives and the Senate proposed that the FDA take more control of the oversight of compounding pharmacies.2 Currently, compounding pharmacies are regulated at the state level. There is a misconception3 that injection of phosphatidylcholine/deoxycholate (PC/DC) or DC alone is illegal in the United States as there is no FDA-approved drug. This is not true. Phosphatidylcholine/deoxycholate or DC alone compounded by a …