Botox Formulations Differ in Onset, Duration for Frown Lines

TOPLINE:

A randomized trial showed quantitative differences between four botulinum toxin A formulations among women treated for glabellar rhytids, with abobotulinum toxin A (ABoNT/A) and prabotulinum toxin A (PBoNT/A) having a faster onset of effect than onabotulinum toxin A (OBoNT/A) and incobotulinum toxin A (IBoNT/A), and PBoNT/A showing a significantly greater effect at 3 months.

METHODOLOGY:

• In a single-center, double-blind randomized clinical trial, 143 women aged 30-65 years were randomly assigned 1:1:1:1 to OBoNT/A, ABoNT/A, PBoNT/A, or IBoNT/A at standard doses.
• Their mean age was 43.5 years; most participants (83.9%) were White, 4.9% were Black, and 4.2% were Asian.
• Participants were followed up at days 3, 30, 90, and 180.
• The primary outcome was glabellar strain, measured using dynamic three-dimensional photogrammetry. The secondary outcome was patient satisfaction, assessed with FACE-Q surveys.

TAKEAWAY:

• Compared with OBoNT/A (48.0%) and IBoNT/A (40.3%), ABoNT/A (67.4%) and PBoNT/A (61.7%) showed a significantly faster onset, with strain reduction observed at day 3 (P < .05 for all comparisons). PBoNT/A maintained a significantly higher strain reduction (20.5%) than OBoNT/A (0.5%; P = .03) at day 180.
• Maximum treatment efficacy most frequently occurred at day 30, with an overall median efficacy of 88% in the total cohort and no significant difference between the treatments at day 30. Maximum efficacy was 89.3% in the OBoNT/A, 93% in the PBoNT/A, and 89.5% in the IBoNT/A groups.
• Increasing baseline glabellar strain severity resulted in proportionally greater improvement with treatment across all formulations.
• FACE-Q scores improved significantly from baseline across all groups by day 30, with most improvements lasting through 6 months and no significant differences between treatment groups. No adverse events were reported.

IN PRACTICE:

“This randomized clinical trial demonstrated precise quantitative differences between 4 BoNT/A formulations in treating glabellar strain,” the study authors wrote, adding that the quantification of the effect of BoNT/A “provides an objective foundation to guide individualized product selection and patient education.”

SOURCE:

The study was led by Mehdi S. Lemdani, BA, University of Pennsylvania, Philadelphia, and was published online on May 28 in JAMA Dermatology.

LIMITATIONS:

Limitations included reduced participant retention at the final visit and inclusion of only female participants. Differential dosing and treatment of adjoining regions were not examined.

DISCLOSURES:

The study was funded by Evolus. Lemdani and three other authors reported receiving grants from Evolus during this study. One author also received personal fees from AbbVie and Galderma.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.