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  • Originally posted by hihohi88 View Post
    Hi,

    I'm a french guy so sorry for my bad english..

    Poppe : i've see you on KP forum but i cant registered on this website, i'm in Europe too, i except this product so much for treat my EXTREME KPRF !

    And a general question, it's work for rosacea (flush et redness), so its must work for the KPRF too (flush and redness but more red) ? :p

    I've send an email to Galderma and Allenby Dermatology for more informations..

    Need this product !!!!!

    HI :P
    My English is too bad :P

    Yes, on http://keratosispilaris.org/forum.php is about me topic.
    Give your e-mail and we'll talk

    I have a friend who has a brother in the U.S., so it can buy Mirvaso.
    But for now zero information from Galderma, on when it will be available.

    Comment


    • I really hope that this won't turn into a huge disappointment. I really don't get how they formulated it to stop rebound. Even xylometazoline ( nasalspray also a vasoconstrictor) can't be used more than a week because of rebound. I think the brimonidine is much stronger.
      I hope we won't be seeing reports about serious side effects..
      Mistica explained everything here:


      Originally posted by Mistica View Post
      I would urge great caution to anyone who contemplates trying this medication.
      I am a brimonidine victim. I ended up in the ER twice with the most horrific rebound flushing. I had nose bleeds, split lips and terrible flushing as the blood surged through my face looking for the weakest route. It would dart about, first engorging the side of my nose, then upper lip area, then the cheek, etc. I have seen another post here where someone else experienced this phenomenon, although in lesser form than me. I suffered permanent damage. My upper right cheek being the worst area. The vasculature continues to be excessive and very dysfunctional. Also, there seems to be nerve damage. I tried it for a couple of months in late 2010 and it is only in these last few months that it has settled down to a point, but I have to be ever vigilante. Even another attempt at IPL didn't help, but it did cause more fat loss.

      The derm who told the world about brimonidine claimed none of his rosacea patients suffered rebound flushing and in fact, only benefited from the drug.
      Given the fact all members here suffered rebound, that is like saying the derms patients don't require oxygen to breathe.
      The mechanics of rosacea and flushing don't change, no matter which physician oversees their care.

      I don't believe the claim that the rebound flushing can be prevented due to the formulation of this newly released product.
      Think about it. Brimonidine is a vasoconstrictor. The body will always try and regain homeostasis.
      When you tinker with receptors, no matter what they are, the body will compensate. Trying to overcome this can only be done with another type of vasconstrictor and that would just add to the problem.

      Even caffeine is a vasoconstrictor. The study done on rosacea and coffee consumption was flawed, only observing the effects of heat on rosaceans.
      The pathways which result in flushing are different.
      Heat is obvious. Caffeine interferes with adenosine receptors, docking in them, and preventing the effects of adenosine, which is vasodilating (there are other effects). So, for a while, the face pales. But as the drug wears off, there is rebound. In addition, caffeine upregulates adenosine receptors, so when caffeine is suddenly stopped, there are excessive receptors. Withdrawal sets in. It is the same process involved with other addictions.

      It is my belief that those who try this drug will initially experience relief and be so delighted with it, they will continue to use it. Then they will find they need a bit more and a bit more as break through flushing sets in. They will require more drug and the rebound will become worse and worse, until the face can't cope at all and awful rebound will set in. The damage could be permanent.

      For those who aren't flushers and think they are safe, think again. If you weren't a flusher to start with, you stand a high chance of becoming one. After all, flushing is simply neurotransmitters gone out of whack.

      I have tried to keep this explanation very simple so it can reach everyone with varied levels of understanding. Those who are capable can always do additional research.

      Some people here are familiar with Prof Ayers, a biochemist I used to chat with. He spent a lot of time trying to shed light on the process of rosacea and flushing. When I was going through brimonidine rebound hell, I pleaded to him for help to stop the process. He said he was not able to and I just had to ride it out. He did add, that my experiment was one of the most foolish things I ever did, as the effect of brimonidine was not unexpected in his view.
      And there comes the problem. Most patients don't know how drugs work. We trust those who prescribe them.
      I didn't know anything about G-receptors back then.

      http://en.wikipedia.org/wiki/Alpha-2...ergic_receptor

      Of course, it could be possible that the newly released drug is different and the scientists have found a way to overcome the problem, but I am highly suspicious they haven't. Even a dilute dose could have the same effects. I diluted mine, by the way.

      Everyone needs to make up their own mind, but for those who try it, I advise a tiny test patch and not to increase that patch for several weeks. Just in case.

      By the way, clonidine is similar. That causes rebound too.
      On the trusting of those that prescribe excellent point:
      How many people have been prescribed steroids for their rosacea! Doctors don't know everything, and most (not all) of them don't keep up with current research. They just do what they learned in medical school (20+ years ago)

      Comment


      • Treating rebound flushing

        Originally posted by Sweeney View Post
        Here's my take on Mirvaso... since it's very unlikely that Galderma has completely solved the rebound flushing/redness issue, it is likely that we all have to expect some degree of rebound. But for a lot of people on here, myslef included, having that 10-12 window with no flushing/redness can be a tremendous help for our lives. That no-redness 'window' that allows enough time to, say, go on a date, sit through a business meeting, get drunk with friends... or whatever.

        Personally, I'm a lawyer and one of the most difficult things for me is going to court. Beleive me it's like a rosacean's worst nightmare: it's hot, you have to wear a ridiculous heavy robe (in Canada), your nervous, and often the judge calls you out and puts you on the spot in front of your client and dozens of spectators (worst and most embarrasing flushing ever!).

        My expectations are this: I will be extremely pleased if I can use this cream once or twice a week with a reasonable and predictable amount of rebound flushing in the evening or the following morning. I just hope I don't react badly to it's non-brimonidine ingredients like I do with 99.9% of other creams.


        I have found that if regular brimonidine is mixed with a mild steroid lotion before application, it totally eliminates any rebound flushing.

        Comment


        • Originally posted by wjs View Post
          I have found that if regular brimonidine is mixed with a mild steroid lotion before application, it totally eliminates any rebound flushing.
          Do we then have the added complication of skin atrophy from the corticosteroid?

          Comment


          • Originally posted by DLhope View Post
            Hey hiho, je suis aussi sur le forum de KP. J'ai cette merde de condition depuis 12 ans et je comprends parfaitement. Je te dis un truc l'ami, j'habite
            à 45 minutes de la frontier américaine. Si ce produit marche et arrive sur le marché avant le Canada et la France, je fonce en voiture le premier jour
            et je suis prêt à te l'envoyer directement chez-vous.

            Aussi si tu as besoin de te faire traduire un message, mon Anglais est presque parfait.
            Mais vous êtes quand même besoin d'un lettre ou un récette d'un médecin pour obtenir cette Mirvaso crème....
            My rosacea related blog: http://scarletnat.blogspot.com/2012/...edication.html

            Comment


            • Originally posted by johnabetts View Post
              Do we then have the added complication of skin atrophy from the corticosteroid?
              It is not such a bad idea, but you would have to use it sparingly...maybe once every week or two. If I try this out (or I should say when I try this out), I wouldn't use it more than once every couple weeks at most. Perhaps it would be good for occasional use, but not sure sure about regular use.

              Comment


              • Originally posted by wiry View Post
                It is not such a bad idea, but you would have to use it sparingly...maybe once every week or two. If I try this out (or I should say when I try this out), I wouldn't use it more than once every couple weeks at most. Perhaps it would be good for occasional use, but not sure sure about regular use.
                Even then, considering this treatment is for life, I doubt it's a good idea.

                Comment


                • Hey hiho, je suis aussi sur le forum de KP. J'ai cette merde de condition depuis 12 ans et je comprends parfaitement. Je te dis un truc l'ami, j'habite
                  à 45 minutes de la frontier américaine. Si ce produit marche et arrive sur le marché avant le Canada et la France, je fonce en voiture le premier jour
                  et je suis prêt à te l'envoyer directement chez-vous.

                  Aussi si tu as besoin de te faire traduire un message, mon Anglais est presque parfait.
                  Salut :p Ce serais super symphatique de ta part si il n'y a pas d'autre moyen pour que je me le procure. Puis se sera plus simple, avec une prescription tu pourras acheter 2 produits et m'en envoyer un (on verras plus tard pour le paiments haha), j'attend déjà de voir si ce produit fonctionne !! Bonne chance pour réussir à te débarrasser de ta KP, j'espère qu'elle n'est pas comme la mienne car j'en ai vraiment partout : tout les bras (avant/arrière), fesse, cuisse, molet, ventre, cou, sourcils tout rouges, joues rouges écarlate. L'HORREUR ! Tu peux maintenant relativiser sur ta situation et tu dire que tu n'as pas la pire des KP.

                  HI :P
                  My English is too bad :P

                  Yes, on http://keratosispilaris.org/forum.php is about me topic.
                  Give your e-mail and we'll talk

                  I have a friend who has a brother in the U.S., so it can buy Mirvaso.
                  But for now zero information from Galderma, on when it will be available.
                  Hello Poppe :p

                  I've give to you my email in PM.
                  I've see your post with photo of your KP, I've i think the same, a little worth than you i think ^^

                  WE ****IN NEED MIRVASO AND MORE INFORMATIONS è.é

                  Cordially and hold on guy !

                  Comment


                  • Some information ahah : http://www.accessdata.fda.gov/drugsa.../204708lbl.pdf

                    Comment


                    • If anyone is interested in the Mirvaso tube and packaging I have a grainy screen capture here: Mirvaso Packaging.
                      Get Rosacea News here - https://rosacea-support.org

                      Comment


                      • Does anyone know what exactly they mean buy.... "The primary efficacy endpoint in both pivotal trials was 2-grade Composite Success, defined as the proportion of subjects with a 2-grade improvement on both CEA and PSA measured at hours 3, 6, 9, and 12 on Day 29. Table 2 presents the efficacy results. In addition to Day 29, efficacy was evaluated on Day 15 and Day 1, and the results are presented in Figures 1 and 2 for Studies 1 and 2, respectively." ??

                        I can not find anything describing clearly how they define success?

                        Comment


                        • Originally posted by Starlite View Post
                          Does anyone know what exactly they mean buy.... "The primary efficacy endpoint in both pivotal trials was 2-grade Composite Success, defined as the proportion of subjects with a 2-grade improvement on both CEA and PSA measured at hours 3, 6, 9, and 12 on Day 29. Table 2 presents the efficacy results. In addition to Day 29, efficacy was evaluated on Day 15 and Day 1, and the results are presented in Figures 1 and 2 for Studies 1 and 2, respectively." ??

                          I can not find anything describing clearly how they define success?
                          good question, id love to know this too. also, a little confused about the rates of adverse effects. Im sure its been cited elsewhere as >1%, however table 1 shows 33% of people have problems over 29 days. Isnt that quite alot? Im not sure how it compares to other topicals like finacea or metrogel

                          Comment


                          • Thank you for your message. At this time, we do not yet have the product and even so are not able to ship any prescription product without first examining a patient. I am so sorry.
                            Reply of a dermatologist.
                            In a video they said "By a prescription (okey we know that) at the end of the month" (month = september), be patient !
                            Last edited by hihohi88; 16 September 2013, 05:50 PM.

                            Comment


                            • Originally posted by lucy_nic87 View Post
                              good question, id love to know this too. also, a little confused about the rates of adverse effects. Im sure its been cited elsewhere as >1%, however table 1 shows 33% of people have problems over 29 days. Isnt that quite alot? Im not sure how it compares to other topicals like finacea or metrogel
                              If I interpret it correctly you should compare it with the "vehicle gel" that has 28% adverse reactions. It is a double blind test so you have people not knowing if they have Mirvaso or the "vehicle". I have no clue what the vehicle is but I sure hope it is something that is really containing something that almost everyone can tolerate but still feel they have adverse reactions.

                              The table is showing the symptoms where Mirvaso had higher rates than the "vehicle".

                              Maybe this was fully understood?

                              I don't really think this study is reliable, not enough people and not enough long term use.

                              I also found this link which talks about the "2-grade", http://dermnetnz.org/treatments/brim...-evidence.html

                              Baseline disease severity was graded using a 5-point Clinician's Erythema Assessment (CEA) scale and a 5-point Patient Self Assessment (PSA) scale, on which subjects scored either “moderate” or “severe” on both scales.


                              Same study but different text.

                              Comment


                              • Originally posted by Tomas View Post
                                If I interpret it correctly you should compare it with the "vehicle gel" that has 28% adverse reactions. It is a double blind test so you have people not knowing if they have Mirvaso or the "vehicle". I have no clue what the vehicle is but I sure hope it is something that is really containing something that almost everyone can tolerate but still feel they have adverse reactions.

                                The table is showing the symptoms where Mirvaso had higher rates than the "vehicle".

                                Maybe this was fully understood?

                                I don't really think this study is reliable, not enough people and not enough long term use.

                                I also found this link which talks about the "2-grade", http://dermnetnz.org/treatments/brim...-evidence.html

                                Baseline disease severity was graded using a 5-point Clinician's Erythema Assessment (CEA) scale and a 5-point Patient Self Assessment (PSA) scale, on which subjects scored either “moderate” or “severe” on both scales.


                                Same study but different text.

                                well in terms of reliability its number of subjects was about half again of the oracea one, so its seems to be a pretty standard clinical trial

                                Comment

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