Long-term Safety and Efficacy of a New Botulinum Toxin Type A in Treating Glabellar Lines

Moy, Ronald L.; Maas, Corey S.; Monheit, Gary D.; Huber, Matthias

doi:10.1001/archfaci.2009.5

Cited by 47 publications

(73 citation statements)

References 8 publications

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“…To the best of our knowledge, this is the first report that demonstrates the effect of different types and dilutions of BoNT‐A toxin on fibroblast contraction. In previous comparisons of ONA to ABO, statistically significant improvements were observed for forehead lines, glabellar frown lines, and crow's feet compared with placebo groups, and a recent comparison of intradermal versus intramuscular BoNT‐A by Sapra et al showed significantly improved skin texture concomitant with a mild midfacial lift. We propose that one potential cellular mechanism underlying this positive outcome is the fibroblast contraction observed here.…”

Section: Discussionmentioning

confidence: 93%

The effect of botulinum toxin type A in different dilution on the contraction of fibroblast—In vitro study

Wanitphakdeedecha

Kaewkes

Ungaksornpairote

et al. 2019

J of Cosmetic Dermatology

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BackgroundBotulinum toxin type A (BoNT‐A) may directly remodel dermal tissues or induce a loss of normal morphology and cytoplasmic retraction and spread. Intradermal injection was claimed to produce a dermo‐lifting effect, including midface lifting by using low concentration with variable dilution.ObjectiveTo understand how intradermal BoNT‐A achieves tissue lifting, we examined different type of BoNT‐A and their effects on dermal fibroblast contraction.MethodsNormal human dermal fibroblasts were treated with onabotulinumtoxin (ONA), abobotulinumtoxin (ABO), prabotulinumtoxinA (PRABO), incobotulinumtoxinA (INCO), and letibotulinumtoxin A (LETI) in dilutions used in real‐world practice. Fifty fibroblasts per dilution were photographed and measured the length to demonstrate their contraction every 2 hours from baseline (0 hours) to 12 hours post‐treatment.ResultsONA did not significantly decrease fibroblast lengths, at any timepoint or dilution. At 1:7 dilution ratios, ABO decreased fibroblast lengths after 2 hours and significantly after 10‐12 hours. At 1:7, 1:8, 1:9, and 1:10 dilution, PRABO decreased length, and most rapidly at 1:7 and 1:8. At 1:6, 1:8, 1:9, and 1:10 dilution, INCO decreased lengths almost immediately. At 1:6 dilution, INCO decreased lengths almost immediately. At 1:7 dilution, INCO decreased lengths after 2‐4 hours, while at 1:8, 1:9, and 1:10 dilution, INCO decreased lenghts nearly imediately. LETI decreased lengths at all dilutions except 1:9, with near‐immediate effects at 1:6, 1:7, 1:8, and 1:10. At 1:4 dilution, LETI decreased lengths from 1 hour.ConclusionsDifferent commercial preparations of BoNT‐A toxins cause different fibroblast contractions in vitro. Product selection and dilution used may affect the clinical outcome of intradermal injection of BoNT‐A for face lifting.

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Section: Discussionmentioning

confidence: 93%

The effect of botulinum toxin type A in different dilution on the contraction of fibroblast—In vitro study

Wanitphakdeedecha

Kaewkes

Ungaksornpairote

et al. 2019

J of Cosmetic Dermatology

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“…Among the patients who reported effect onset with incoBTX-A treatment, the median result was 8.5 days, longer than the median onset of effect with aboBTX-A treatment reported in the literature of 3 days. [21,22] Limitations of our study include its small sample size, larger studies are warranted to better establish dose equivalency between aboBTX-A and incoBTX-A. IncoBTX-A injections were performed without cost to the patient, and this may have affected patient satisfaction rates.…”

Section: Discussionmentioning

confidence: 99%

Patient-centric dose equivalency pilot study of incobotulinumtoxin a (xeomin) vs. abobotulinumtoxin a (dysport) in the treatment of glabellar frown lines

2015

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Aim: Incobotulinumtoxin A (xeomin) has been proposed as an alternative to abobotulinumtoxin A (dysport) and onabotulinumtoxin A (Botox) in the treatment of glabellar frown lines. A recent study is comparing abobotulinumtoxin A and onabotulinumtoxin A revealed equivalent efficacy with a dose conversion ratio of 2.5:1. We sought to establish effectiveness and dosing equivalency of incobotulinumtoxin A vs. abobotulinumtoxin A. Methods: Inclusion criteria for this pilot study included patients of a single surgeon (LAC) who had previously received a constant dose of abobotulinumtoxin A over at least four consecutive treatment sessions for the previous 12 months to achieve an 85-90% elimination of dynamic glabellar frown lines. The primary outcome sought dose comparison between established maintenance abobotulinumtoxin A dosing and incobotulinumtoxin A first-time dosing. A 2:1 conversion (abobotulinumtoxin A: incobotulinumtoxin A) was chosen in most patients. Secondary outcomes were patient-reported onset of effect, physician-assessed effect at 10-12 weeks, pain associated with administration, and patient perceived need for re-treatment at 2 weeks. Results: A total of 32 subjects were included. The mean dose of incobotulinumtoxin A was 17.1 units (± 6.1, the median dose 20 units). The mean dose of abobotulinumtoxin A was 27.6 (± 11.7, the median dose 27.5 units). The mean difference in treatment units was-10.5 (95% confidence interval, P < 0.001). Among 30 patients who reported effect onset, the median was 8.5 days, with a range of 1-14. At 10-12 weeks, muscle paralysis was assessed to be 69.2% (± 27.3), vs. 90.3% (± 1.8) with abobotulinumtoxin A (P < 0.001). The majority of patients rated pain of administration as equal or greater to that of abobotulinumtoxin A (63% and 22%, respectively). Three patients (9%) required re-treatment at 2 weeks with abobotulinumtoxin A due to lack of effective treatment with incobotulinumtoxin A. Abobotulinumtoxin A re-treatment was chosen by the patient. Conclusion: We found incobotulinumtoxin A at 17.1 (± 6.1) units to be less effective than abobotulinumtoxin A at 27.6 (± 11.7) units in the treatment of glabellar frown lines at 10-12 weeks postadministration. Dosing was less predictable than dosing associated with abobotulinumtoxin A treatment. Larger, randomized controlled trials are indicated to further delineate these differences and to clarify whether this difference from previously published incobotulinumtoxin A dosing may have been due to the small sample size.

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“…Although a feared complication, there is an approximate 1 to 6% risk of eyelid ptosis with glabellar neuromodulator injections. 5 Treatment consists first and foremost of patient reassurance. In the majority of cases, the ptosis resolves within 3 weeks as the neuromodulator's effect wears off.…”

Section: Eyelid Ptosismentioning

confidence: 99%

Facial Filler and Neurotoxin Complications

Nettar

Maas

2012

Facial plast Surg

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Long-term Safety and Efficacy of a New Botulinum Toxin Type A in Treating Glabellar Lines

Cited by 47 publications

References 8 publications

The effect of botulinum toxin type A in different dilution on the contraction of fibroblast—In vitro study

The effect of botulinum toxin type A in different dilution on the contraction of fibroblast—In vitro study

Patient-centric dose equivalency pilot study of incobotulinumtoxin a (xeomin) vs. abobotulinumtoxin a (dysport) in the treatment of glabellar frown lines

Facial Filler and Neurotoxin Complications

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