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A Double-Blind Prospective Study Comparing Patient Satisfaction Between Four Types Of Botulinum Toxin A Treatments In The Glabellar Region
Mehdi S. Lemdani, BA, Jane N. Ewing, BS, Stephanie E. Honig, MD, Theodore E. Habarth-Morales, BS, Harrison D. Davis, BS, Ellen F. Niu, BS, Chris Amro, MD, Zachary Gala, MD, Robyn B. Broach, PhD, Ivona Percec, MD, PhD.
University of Pennsylvania, Philadelphia, PA, USA.
PURPOSE: Multiple botulinum toxin formulations are FDA-approved and commercially available for patients and physicians to consider for aesthetic improvement of the glabellar rhytids. Our study provides quantitative results to differentiate patient-reported outcomes (PROs) after glabellar injection with four different Botulinum Toxin type-A neurotoxins.
METHODS: A double-blind randomized control trial was conducted by randomizing 143 patients into four cohorts that received either Botox, Dysport, Jeuveau, or Xeomin at standardized sites and dosing of the glabella. The FACE-Q, a validated survey for PROs, was administered pre-injection as well as at 3-, 30-, 90-, and 180-days post-injection. Median difference in FACE-Q scores at each visit was determined using pre-injection scores as a reference. Satisfaction by toxin was evaluated at each visit.
RESULTS: When comparing forehead-related FACE-Q modules (FRMs), all cohorts experienced significant improvement in scores up to 90 days compared to their pre-procedure scores (p<0.05; Figure). However, the Xeomin cohort remained significantly above the pre-injection score at 180 days while other cohorts did not (p<0.05). When examining FRM scores at each visit, there was no clinically significant difference between the tested neurotoxins (p>0.05).
CONCLUSIONS: As the largest PRO study comparing four approved Botulinum Toxin type A formulations for the glabellar region, our study demonstrates significant improvement in PROs with each neurotoxin tested up to 90 days post-procedure. However, patients receiving Xeomin report superior perceived outcomes at 180 days.
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