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Hong SO. Cosmetic Treatment Using Botulinum Toxin in the Oral and Maxillofacial Area: A Narrative Review of Esthetic Techniques. Toxins (Basel) 2023; 15:toxins15020082. [PMID: 36828397 PMCID: PMC9964918 DOI: 10.3390/toxins15020082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 01/18/2023] Open
Abstract
Botulinum toxin (BoNT) is an anaerobic rod-shaped-neurotoxin produced by Clostridium botulinum, that has both therapeutic and lethal applications. BoNT injection is the most popular cosmetic procedure worldwide with various applications. Patients with dynamic wrinkles in areas such as the glabella, forehead, peri-orbital lines, nasal rhytides, and perioral rhytides are indicated. Excessive contraction of muscles or hyperactivity of specific muscles such as bulky masseters, cobble stone chins, gummy smiles, asymmetric smiles, and depressed mouth corners can achieve esthetic results by targeting the precise muscles. Patients with hypertrophic submandibular glands and parotid glands can also benefit esthetically. There are several FDA-approved BoNTs (obabotuli-numtoxinA, abobotulinumtoxinA, incobotulinumtoxinA, letibotulinumtoxinA, prabotulinumtox-inA, daxibotulinumtoxinA, rimbotulinumtoxinB) and novel BoNTs on the market. This paper is a narrative review of the consensus statements of expert practitioners and various literature on the injection points and techniques, highlighting both the Asian and Caucasian population separately. This paper can serve as a practical illustrative guide and reference for optimal, safe injection areas and effective doses for application of BoNT in the face and oral and maxillofacial area. The history of BoNT indications, contraindications, and complications, and the merits of ultrasonography (US)-assisted injections are also discussed.
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Affiliation(s)
- Sung Ok Hong
- Department of Oral and Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Hospital at Gangdong, Seoul 05278, Republic of Korea
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Cavallini M, Papagni M, Lazzari R, Santorelli A. Botulinum Toxin Type A: Adverse Events and Management. Facial Plast Surg 2022; 38:111-115. [PMID: 35130564 DOI: 10.1055/s-0041-1741531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Aesthetic medicine is witnessing an increasing exploitation of all the procedures. The demand has never been higher than it is today. The number of practitioners is also increasing year by year. Consequently complications and other kinds of related troubles and procedures are also rising. Never like today is fundamental, in case of troubles, how to properly manage with the most frequent issues. In aesthetic medicine field, botulinum toxin procedures are the safest. Lot of patients are worried about botulinum toxin despite the available scientific literature. Rare short-term complications are observed. In the most of cases, nothing severe occurs if the international recommendations and the most recent guidelines are closely followed, the majority of them are injection related. This study is a review of rare or common problems that can occur and how to manage or solve the situations.
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Affiliation(s)
- Maurizio Cavallini
- Operative Unit of Dermatology and Dermato-Surgery, Centro Diagnostico Italiano Hospital, Milan, Italy
| | - Marco Papagni
- Italian Scientific Society of Aesthetic Medicine, Milan, Italy
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Signorini M, Piero Fundarò S, Bertossi D, Cavallini M, Cirillo P, Natuzzi G, Quartucci S, Sciuto C, Patalano M, Trocchi G. OnabotulinumtoxinA from lines to facial reshaping: A new Italian consensus report. J Cosmet Dermatol 2022; 21:550-563. [DOI: 10.1111/jocd.14728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/22/2021] [Indexed: 02/06/2023]
Affiliation(s)
| | | | - Dario Bertossi
- Section of Oral and Maxillofacial Surgery Department of Surgical Sciences University of Verona Verona Italy
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Kandhari R, Imran A, Sethi N, Rahman E, Mosahebi A. Onabotulinumtoxin Type A Dosage for Upper Face Expression Lines in Males: A Systematic Review of Current Recommendations. Aesthet Surg J 2021; 41:1439-1453. [PMID: 33532814 DOI: 10.1093/asj/sjab015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Botulinum toxin injection is the most commonly performed minimally invasive aesthetic procedure in men. Despite various recommendations by experts on the use of onabotulinumtoxin type A in the literature, distinct guidelines for its use in males and females do not exist. OBJECTIVES The aim of this study was to delineate safe and effective doses for the use of onabotulinumtoxin type A in males for correction of upper facial expression lines. METHODS PubMed (MEDLINE), Embase, the Cochrane database, and Google Scholar were searched from 2002 to 2019 inclusive. Three researchers independently assessed trials for inclusion, extracted data, checked for accuracy, and assessed the evidence with AGREE II. RESULTS Average dosing recommended for the treatment of upper face expression lines was specific to glabellar frown lines, crow's feet, and horizontal forehead lines. Changing trends and gender variation was noted in each of the studies. Six of the 11 recommendations suggest the need to alter dosing in male patients, although do not give separate recommendations. CONCLUSIONS There is an urgent need for up-to-date recommendations for the use of onabotulinumtoxin type A in upper face expression lines of male patients.
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Affiliation(s)
| | - Al Imran
- Division of Surgical and Interventional Science, University College London, London, UK
| | | | - Eqram Rahman
- Plastic and Reconstructive Surgery, Royal Free Hospital and University College London, London, UK
| | - Afshin Mosahebi
- Plastic and Reconstructive Surgery, Royal Free Hospital and University College London, London, UK
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OnabotulinumtoxinA for Simultaneous Treatment of Upper Facial Lines: Subject-Reported Satisfaction and Impact From a Phase 3 Study. Dermatol Surg 2020; 46:50-60. [PMID: 30829771 DOI: 10.1097/dss.0000000000001883] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patient-reported outcomes are increasingly recognized as important measures of treatment benefit. OBJECTIVE To evaluate subject-reported satisfaction and impact outcomes with onabotulinumtoxinA treatment in neurotoxin-naive adults with forehead lines (FHL), glabellar lines (GL), and crow's feet lines (CFL). METHODS This Phase 3 study randomized 787 subjects to onabotulinumtoxinA 64 U (FHL 20 U, GL 20 U, and CFL 24 U), 40 U (FHL 20 U, GL 20 U, and CFL placebo), or placebo in double-blind Period 1. Subjects could receive up to 2 additional 64 U treatments in open-label Period 2. Patient-reported outcomes were assessed using the validated Facial Line Satisfaction Questionnaire (FLSQ) and 11-item Facial Line Outcomes (FLO-11) Questionnaire. RESULTS The proportion of subjects mostly or very satisfied was significantly greater with onabotulinumtoxinA 64 U and 40 U versus placebo (87.9% and 81.4% vs 3.2%; p < .0001). Responder rates on FLSQ Impact Domain, FLO-11 Items 1, 4, 5, and total score were significantly greater with onabotulinumtoxinA versus placebo on Day 30 (p < .0001). Responder rates favoring onabotulinumtoxinA in Period 1 were maintained with repeated onabotulinumtoxinA 64 U treatment in Period 2. CONCLUSION OnabotulinumtoxinA treatment was associated with high subject satisfaction and significant improvements in appearance-related psychological and emotional impacts.
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D'Emilio R, Rosati G. Full‐face treatment with onabotulinumtoxinA: Results from a single‐center study. J Cosmet Dermatol 2019; 19:809-816. [DOI: 10.1111/jocd.13130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/12/2019] [Indexed: 11/26/2022]
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OnabotulinumtoxinA for Treatment of Forehead and Glabellar Lines: Subject-Reported Satisfaction and Impact From a Phase 3 Double-Blind Study. Dermatol Surg 2019; 45:689-699. [PMID: 31034447 DOI: 10.1097/dss.0000000000001779] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient-reported outcomes are important measures of treatment benefit in facial aesthetic medicine. OBJECTIVE Evaluate prespecified subject-reported satisfaction and impact outcomes with onabotulinumtoxinA treatment of forehead lines (FHL) and glabellar lines (GL). METHODS The study randomized (3:1) 391 adults with moderate to severe FHL and GL to onabotulinumtoxinA (FHL, 20 U; GL, 20 U) or placebo in double-blind period 1 (days 0-180); subjects could receive up to 2 additional onabotulinumtoxinA treatments in open-label period 2. Patient-reported outcomes were assessed using the validated Facial Line Satisfaction Questionnaire (FLSQ) and the 11-item Facial Line Outcomes (FLO-11) Questionnaire. RESULTS The proportion of subjects mostly or very satisfied with treatment was significantly greater with onabotulinumtoxinA than with placebo (90.3% vs 1.0%; p < .0001). Responder rates on FLSQ Impact Domain (73.9% vs 18.9%), FLO-11 Item 1 (85.4% vs 3.6%), Item 4 (77.2% vs 11.2%), Item 5 (83.5% vs 7.8%), and total score (86.0% vs 6.9%) were significantly greater with onabotulinumtoxinA than with placebo on Day 30 (p < .0001). Responder rates favoring onabotulinumtoxinA in Period 1 were generally maintained with repeated treatment during Period 2. CONCLUSION Subjects were highly satisfied with onabotulinumtoxinA treatment and reported significant improvements in appearance-related psychological and emotional impacts of their facial lines.
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Phase 3 Study of OnabotulinumtoxinA Distributed Between Frontalis, Glabellar Complex, and Lateral Canthal Areas for Treatment of Upper Facial Lines. Dermatol Surg 2018; 44:1437-1448. [PMID: 30096106 DOI: 10.1097/dss.0000000000001612] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although commonly practiced, simultaneous onabotulinumtoxinA injections to multiple facial areas have not been investigated in prospective studies. OBJECTIVE Evaluate safety and efficacy of onabotulinumtoxinA for treatment of forehead lines (FHL) distributed between the frontalis (20 U) and glabellar complex (20 U), with or without simultaneous lateral canthal areas (crow's feet lines [CFL], 24 U) treatment. METHODS Subjects with moderate to severe FHL were randomized (2:2:1) to onabotulinumtoxinA 40 U, onabotulinumtoxinA 64 U, or placebo. After 180 days, subjects could receive up to 2 additional open-label onabotulinumtoxinA 64 U treatments. RESULTS The intent-to-treat (ITT) population comprised 787 subjects, and the modified ITT (mITT) population (subjects with psychological impact) comprised 568. After 30 days, onabotulinumtoxinA 40 U and 64 U significantly improved investigator- and subject-assessed FHL severity by at least 2 Facial Wrinkle Scale (FWS) grades in 45.6% and 53.0% of ITT subjects, respectively, versus 0.6% receiving placebo (both, p < .0001). Significantly more mITT subjects receiving onabotulinumtoxinA achieved investigator- and subject-assessed FWS ratings of none/mild versus placebo (p < .0001). OnabotulinumtoxinA was well tolerated. CONCLUSION OnabotulinumtoxinA distributed between the frontalis and glabellar complex, with or without additional CFL injections, was safe and effective for treatment of moderate to severe FHL.
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Anido J, Arenas D, Arruabarrena C, Domínguez-Gil A, Fajardo C, Mira M, Murillo J, Ribé N, Rivera H, Ruiz Del Cueto S, Silvestre H, Tirado M. Tailored botulinum toxin type A injections in aesthetic medicine: consensus panel recommendations for treating the forehead based on individual facial anatomy and muscle tone. Clin Cosmet Investig Dermatol 2017; 10:413-421. [PMID: 29089780 PMCID: PMC5655032 DOI: 10.2147/ccid.s138274] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Facial lines and wrinkles are strongly influenced by individual differences in anatomy and muscle activity and no single injection protocol will suit all patients. However, there is only limited information in the published literature on how to develop a tailored approach to botulinum toxin treatment. METHODS An expert panel of physicians was convened to establish a consensus on developing an individualized approach to treatment of the forehead with incobotulinumtoxinA. Separate treatment protocols were developed for men and women and subdivided by background level of muscle activity: kinetic, hyperkinetic, and hypertonic. Each muscle tone category was then further subdivided to take account of individual characteristics that can influence treatment. RESULTS Consensus members describe how to perform a dynamic assessment to optimize the dose and injection technique for each patient. A tailored treatment protocol is described for men and women with a wide range of forehead presentations. For each presentation, units of toxin as well as the precise location of injection points were defined by creating a 12-zone map of the forehead. CONCLUSION These recommendations depart from traditional consensus documents by providing detailed incobotulinumtoxinA injection protocols for the forehead based on the major parameters that differ between patients, including muscular anatomy, size, and tone. It is expected that the use of this document will lead to more satisfactory, natural, and individualized aesthetic outcomes for patients.
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IncobotulinumtoxinA for Aesthetic Indications: A Systematic Review of Prospective Comparative Trials. Dermatol Surg 2017; 43:959-966. [PMID: 28375973 DOI: 10.1097/dss.0000000000001076] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND IncobotulinumtoxinA is a botulinum toxin type A (BoNTA) indicated for temporary improvement in the appearance of upper facial lines with well-established efficacy and safety profiles. Whether incobotulinumtoxinA and other BoNTAs are equipotent is subject of debate. OBJECTIVE To compare the efficacy of incobotulinumtoxinA and other BoNTAs for aesthetic applications. MATERIALS AND METHODS PubMed and Embase were systematically searched for prospective clinical trials comparing incobotulinumtoxinA with onabotulinumtoxinA, abobotulinumtoxinA, or placebo for aesthetic applications. RESULTS Fifteen articles met the selection criteria. Two studies found that incobotulinumtoxinA was noninferior or equivalent to onabotulinumtoxinA for the treatment of glabellar frown lines (GFLs). Eight studies found no difference in efficacy between incobotulinumtoxinA and other BoNTAs. One study suggested differences in response rates at certain time points between incobotulinumtoxinA and onabotulinumtoxinA for GFLs, and one suggested differences for dynamic horizontal forehead lines but not for GFLs or lateral periorbital lines, but both had study design issues limiting the ability to draw conclusions. Finally, 3 placebo-controlled studies demonstrated the efficacy of incobotulinumtoxinA for treating GFLs and upper facial lines. CONCLUSION The weight of the evidence from comparative clinical trials indicates that incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA have similar efficacy for aesthetic applications.
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Abstract
Botulinum toxin (BoNT) has been approved for aesthetic use since 2002. Since then, clinical studies and expert use have informed our understanding of how BoNT exerts its clinical effect and the practical use of this product across a number of aesthetic applications. This review discusses the clinical properties and characteristics of abobotulinumtoxinA, which patients are suitable for its use, and how it can be utilized to treat facial rhytides.
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Affiliation(s)
| | - Gary Monheit
- Dermatologist, Departments of Dermatology and Ophthalmology, University of Alabama at Birmingham, Birmingham, AL, USA
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Abstract
Botulinum neurotoxin injections are a valuable treatment modality for many therapeutic indications and have revolutionized the field of aesthetic medicine so that they are the leading cosmetic procedure performed worldwide. Studies show that onabotulinumtoxinA, abobotulinumtoxinA, and incobotulinumtoxinA are comparable in terms of clinical efficacy. Differences between the products relate to the botulinum neurotoxin complexes, specific biological potency, and their immunogenicity. Protein complex size and molecular weight have no effect on biological activity, stability, distribution, or side effect profile. Complexing proteins and inactive toxin (toxoid) content increase the risk of neutralizing antibody formation, which can cause secondary treatment failure, particularly in chronic disorders that require frequent injections and long-term treatment. These attributes could lead to differences in therapeutic outcomes, and, given the widespread aesthetic use of these three neurotoxin products, physicians should be aware of how they differ to ensure their safe and effective use.
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Affiliation(s)
- Jürgen Frevert
- Head of Botulinum Toxin Research, Merz Pharmaceuticals GmbH, Hermannswerder 15, 14473, Potsdam, Germany,
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Nassri A, Ramzan Z. Pharmacotherapy for the management of achalasia: Current status, challenges and future directions. World J Gastrointest Pharmacol Ther 2015; 6:145-55. [PMID: 26558149 PMCID: PMC4635155 DOI: 10.4292/wjgpt.v6.i4.145] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/06/2015] [Accepted: 10/16/2015] [Indexed: 02/06/2023] Open
Abstract
This article reviews currently available pharmacological options available for the treatment of achalasia, with a special focus on the role of botulinum toxin (BT) injection due to its superior therapeutic effect and side effect profile. The discussion on BT includes the role of different BT serotypes, better pharmacological formulations, improved BT injection techniques, the use of sprouting inhibitors, designer recombinant BT formulations and alternative substances used in endoscopic injections. The large body of ongoing research into achalasia and BT may provide a stronger role for BT injection as a form of minimally invasive, cost effective and efficacious form of therapy for patients with achalasia. The article also explores current issues and future research avenues that may prove beneficial in improving the efficacy of pharmacological treatment approaches in patients with achalasia.
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Yutskovskaya Y, Gubanova E, Khrustaleva I, Atamanov V, Saybel A, Parsagashvili E, Dmitrieva I, Sanchez E, Lapatina N, Korolkova T, Saromytskaya A, Goltsova E, Satardinova E. IncobotulinumtoxinA in aesthetics: Russian multidisciplinary expert consensus recommendations. Clin Cosmet Investig Dermatol 2015; 8:297-306. [PMID: 26089695 PMCID: PMC4467658 DOI: 10.2147/ccid.s72301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although there are various international consensus recommendations on the use of botulinum neurotoxin type A (BoNT/A) in facial aesthetics, there are no global or Russian guidelines on the optimal dose of incobotulinumtoxinA, free from complexing proteins, within specific aesthetic indications. This article reports the outcomes of two expert consensus meetings, conducted to review and analyze efficacy and tolerability data for incobotulinumtoxinA in various facial aesthetic indications and to give expert consensus recommendations to ensure best clinical practice among Russian clinicians. METHODS Thirteen dermatology and/or plastic surgery experts attended meetings held in Paris, France (November 2013), and Moscow, Russia (March 2014). The expert group reviewed and analyzed the existing evidence, consensus recommendations, and Russian experts' extensive practical experience of incobotulinumtoxinA in aesthetics to reach consensus on optimal doses, potential dose adjustments, and injection sites of incobotulinumtoxinA for facial aesthetics. RESULTS All experts developed guidance on the optimal doses for incobotulinumtoxinA treatment of different regions of the upper and lower face. The expert panel agreed that there are no differences in the efficacy and duration of the effect between the four BoNT/As that are commercially available for facial aesthetic indications in Russia and that, when administered correctly, all BoNT/As can achieve optimal results. Experts also agreed that nonresponse to BoNT/A can be caused by neutralizing antibodies. CONCLUSION On the basis of the scientific and clinical evidence available for incobotulinumtoxinA, coupled with the extensive clinical experience of the consensus group, experts recommended the optimal doses of incobotulinumtoxinA effective for treatment of wrinkles of the upper and lower face to achieve the expected aesthetic outcome. These first Russian guidelines on the optimal use of incobotulinumtoxinA for augmentation of glabellar lines, periorbital wrinkles, forehead lines, bunny lines, perioral wrinkles, depressor anguli oris, mentalis, masseters and platysmal bands, and performing the Nefertiti lift, are presented here.
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Affiliation(s)
- Yana Yutskovskaya
- Department of Dermatovenereology and Cosmetology, Pacific State Medical University, Vladivostock, Russia
| | - Elena Gubanova
- Department of Skin and Venereal Diseases, Postgraduate Medical Institute, Moscow National University of Food Production, Moscow, Russia
| | - Irina Khrustaleva
- Department of Plastic Surgery, IP Pavlov Medical State University, St Petersburg, Russia
| | - Vasiliy Atamanov
- Department of Reconstructive and Plastic Surgery, SN Fedorova, Federal State Institution, Novosibirsk, Russia
| | | | | | | | - Elena Sanchez
- Eklan Medical Center of Cosmetological Correction, Moscow, Russia
| | - Natalia Lapatina
- Clinic of Aesthetic Medicine and Plastic Surgery, Moscow, Russia
| | - Tatiana Korolkova
- Department of Cosmetology, II Mechnikov North-Western State Medical University, St Petersburg, Russia
| | - Alena Saromytskaya
- Plastic Surgery Clinic, Center of Aesthetic Medicine and Beauty Cosmetology, Tyumen, Russia
| | | | - Elmira Satardinova
- Botulinum Toxin Therapy Department, Diagnostic Center of the Irkutsk State Medical Academy of Postgraduate Education, Irkutsk, Russia
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Pavicic T, Prager W, Klöppel M, Ravichandran S, Galatoire O. IncobotulinumtoxinA use in aesthetic indications in daily practice: a European multicenter, noninterventional, retrospective study. Clin Cosmet Investig Dermatol 2015; 8:135-42. [PMID: 25834463 PMCID: PMC4358057 DOI: 10.2147/ccid.s74519] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Purpose To characterize utilization patterns and treatment satisfaction with incobotulinumtoxinA for aesthetic indications and assess adherence to the Summary of Product Characteristics. Patients and methods Data were collected retrospectively from physicians in Germany, France, and the UK regarding patients (n=638) treated with incobotulinumtoxinA for aesthetic indications. Data on indication, treatment interval, dose injected, physician and patient satisfaction, and adverse drug reactions were recorded according to routine daily practice. Results Most patients (76.0%) received incobotulinumtoxinA for glabellar frown lines (GFL) and were given doses of ≤20 U. The majority of treatment intervals were 5 months or longer. Overall, 64.1% of patients were treated for off-label indications, sometimes in combination with treatment for GFL. The most frequently treated off-label indications were horizontal forehead lines (38.6%) and/or crow’s feet (CF; 31.7%); for CF, >95% of injected doses were ≤24 U. In Germany, a smaller proportion of patients were given incobotulinumtoxinA treatment for CF (27.6%), compared with France (40.4%) and the UK (33.2%), although country-specific differences were less prominent when treatment cycle data for CF were examined. Treatment satisfaction among physicians and patients (overall, and for GFL specifically) was very high, with excellent tolerability and only one mild adverse drug reaction reported. Conclusion In daily practice, incobotulinumtoxinA is mainly used for GFL; however, its use for CF and horizontal forehead lines (often in combination with GFL) is relatively common. Treatment satisfaction across aesthetic indications is high, and incobotulinumtoxinA is well tolerated, with time intervals of 5 months or longer between injections in the majority of cases. When considering factors such as dose and treatment interval, adherence to the Summary of Product Characteristics when treating GFL in daily practice is good. These results support previous reports that incobotulinumtoxinA is an effective treatment for GFL, with an excellent safety profile. Furthermore, incobotulinumtoxinA may display efficacy and tolerability in other indications.
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Affiliation(s)
| | - Welf Prager
- Dr. Prager & Partner, Derma-Hamburg, Hamburg, Germany
| | - Markus Klöppel
- Private Practice Clinic of Esthetic Surgery, MediCenter Munich-Solln, Munich, Germany
| | | | - Olivier Galatoire
- Department of Ophthalmology, Adolphe Rothschild Ophthalmological Foundation, Paris, France
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A Prospective Rater- and Subject-Blinded Study Comparing the Efficacy of IncobotulinumtoxinA and OnabotulinumtoxinA to Treat Crow's Feet. Dermatol Surg 2015; 41 Suppl 1:S39-46. [DOI: 10.1097/dss.0000000000000262] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Banegas RA, Farache F, Rancati A, Chain M, Gallagher CJ, Chapman MA, Caulkins CA. The South American Glabellar Experience Study (SAGE): a multicenter retrospective analysis of real-world treatment patterns following the introduction of incobotulinumtoxinA in Argentina. Aesthet Surg J 2013; 33:1039-45. [PMID: 23990584 DOI: 10.1177/1090820x13503475] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND IncobotulinumtoxinA was approved in Argentina in 2007 for the treatment of moderate to severe glabellar lines. OBJECTIVE The authors evaluate real-world changes in facial aesthetic treatment patterns and patient satisfaction following the introduction of incobotulinumtoxinA in Argentina. METHODS This multicenter, retrospective chart review conducted in Argentina included women who had received at least 2 treatment cycles of onabotulinumtoxinA (Allergan, Irvine, California) for glabellar lines (period 1) prior to switching to incobotulinumtoxinA (Merz Pharma, GmbH, Frankfurt, Germany (period 2). Subjects were given the option to continue with incobotulinumtoxinA treatments (captured in period 2) or switch back to onabotulinumtoxinA (documented as period 3). Medical records were reviewed for demographics, dosing, reason for switching between products, treatment satisfaction, and interval between injection cycles. RESULTS One hundred ten women were enrolled and collectively received 662 treatment cycles with botulinum toxin. Subjects were switched to incobotulinumtoxinA at unit doses that were numerically and statistically similar to the onabotulinumtoxinA doses they received in period 1. Most subjects (92%) initially switched to incobotulinumtoxinA because of lower cost. Ninety-two subjects (84%) switched back to onabotulinumtoxinA in period 3, most commonly due to insufficient duration of effect with incobotulinumtoxinA (61/92; 66%). Subjects reported satisfaction with treatment in >90% of their onabotulinumtoxinA visits and in 34% of their incobotulinumtoxinA visits. Median interinjection intervals with onabotulinumtoxinA were 180.3 days (period 1) and 176.9 days (period 3) and 144.3 days with incobotulinumtoxinA in period 2. CONCLUSIONS In this real-world setting, subjects did not appear to perceive the same facial aesthetic benefits from incobotulinumtoxinA as onabotulinumtoxinA when the products were administered at comparable doses.
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Affiliation(s)
- Raúl A Banegas
- Dr Banegas, Dr Farache, and Dr Rancati are plastic surgeons in private practice in Buenos Aires, Argentina
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