Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, MBA, PhD, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not avotermin is a safe and effective treatment for scar improvement in healthy males and females.

STUDY DESIGN: Systemic review of three primary research studies published in the English language, one published in 2010 and the other two in 2011.

DATA SOURCES: Two randomized placebo controlled phase II trials and one double blind within patient placebo controlled phase II clinical trial, analyzed and compared the effectiveness in the administration of avotermin against a placebo in the improvement and diminution of scars. All articles were found using Pubmed and Cochrane Library EBM databases.

OUTCOMES MEASURED: Each of the studies measured the effectiveness of avotermin to improve appearance and reduce size of scar after surgery procedure. In order to determine reduction of size and improvement of appearance total scar score (ToScar) derived from a visual analogue score (VAS) was used pre and post intervention. So, et al. also used Global scar comparison scale, silicone molds evaluated with PRIMOS scale and histological evaluation of tissue

RESULTS: The study by Bush et al reported p=0.0031 and p=0.0140 for avotermin 200ng once or twice respectively at 12 month and 61% of adverse events in experimental group. The study by McCollum et al reported, RR= 6.4, RRR=540%, ARR: 27% NNT= 4 and p=0.007 at 12 month. In addition, RRI=-8%, ARI=-1.3% and NNH=-77. Similar results were obtained in the study by So K et al which reported p= 0.04 at 12 month and RRI=11%, ARI=5% and NNH=20. All studies reported minimal adverse reactions to avotermin in addition to statistical significance in favor of the experimental drug avotermin as an effective treatment for scar improvement.

CONCLUSIONS: Based on the congruency of the data analyzed in these trials, avotermin is safe and effective for treatment of scar reduction and improvement which warrants the use of the drug.

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