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Treating beyond the diagnosis involves helping patients navigate the potentially confusing world of OTC products, according to an expert. Key developments from 2006 include moisturizing body cleansers, timed- release moisturization, enhanced UVA protection and therapeutic fabrics.
"Long-term success is determined by treatment beyond the diagnosis," says Zoe D. Draelos, clinical associate professor of dermatology, Wake Forest University School of Medicine, Winston-Salem, N.C.
However, she adds, "This is an uncomfortable area for many dermatologists," because OTC products are not always evidence-based. Furthermore, confusing advertising claims and rapid product introductions can be overwhelming.
Several factors recently have focused many manufacturers 'attention on OTC products.
"An increased emphasis on generic conversion has decreased research interest in new molecules," while cutting the amount of funding available for such research, Dr. Draelos tells Dermatology Times.
"The rapidity of generic conversion makes it more difficult for a company to earn a profit on a drug," she adds.
"People are not willing to put a lot of money toward research and development because that's a very expensive and sometimes unproductive undertaking."
At the same time, the climate surrounding new drug approvals has been uncertain. Last year saw fewer new drug approvals than 2005, and the Food and Drug Administration (FDA) continues to redefine what it considers a safe drug in the wake of the Vioxx (rofecoxib, Merck) recall, according to Dr. Draelos.
"No drug is 100 percent safe," she says.
Therefore, the pharmaceutical industry and physicians struggle with questions such as, "What is the American public willing to tolerate?"
"Much of the litigation that has occurred surrounding drugs and their side effects may have caused a lot of concern," Dr. Draelos adds.
"Many companies are now looking to either purchase products from outside or to incorporate cosmeceuticals into their lines," she says.
For example, Stiefel Laboratories is developing a cream containing coffee berry extract to complement its prescription products.
Keeping up with the curve
To help dermatologists keep abreast of the OTC product arena, Dr. Draelos offers a recap of key developments from 2006 (based on research conducted at her facility, Dermatology Consulting Services, High Point, N.C.).
Dr. Draelos conducted a four-week study involving 60 atopic dermatitis patients. Those that used a corticosteroid and MVE achieved a statistically significant improvement (p<0.05; unpublished), she says.
"As the number of new actives is shrinking," Dr. Draelos adds, "new delivery systems are becoming more important." Additionally, she says manufacturers could adapt MVE to prescription products.