Dercum's Disease: A Practical Review of Existing and Novel Therapies

Dercum's disease is a rare, incurable condition characterized by painful lipomas distributed throughout the body for which there is no standard care protocol. Current treatment focuses on pain control through medication and surgical intervention. However, available management options only provide temporary relief. This practical review aims to condense the available therapeutic approaches for Dercum's disease.

A literature review was conducted on multiple online databases to identify articles published between 1976 and 2025. Keywords included "Dercum's disease," "adiposis dolorosa," and "treatment." This search yielded 5 novel therapies to treat symptoms of Dercum's disease.

Infliximab, which is traditionally used as an autoimmune medication targeting tumor necrosis factor alpha showed a visual reduction in lipoma size, as well as an improvement in subjective pain grading. Deoxycholic acid (DCA) is a bile acid found naturally in the body that helps to emulsify fat in the intestines. Subcutaneous injection of DCA resulted in both an objective lowering of pain and decreased size of lipomas. CBL-514 is a first-in-class small-molecule inhibitor that induces apoptosis in adipose tissue. It is currently in phase 2 clinical trials and has yielded statistically significant reduction in lipoma size resulting in it receiving Fast Track distinction from the Food & Drug Administration.

Current management of Dercum's disease revolves around medications and surgical intervention, which provide transient results and can be limited in certain populations. Novel studies are looking into off-target therapy options with the goal of presenting long-term treatment choices for clinicians to enhance management of this debilitating disease.