Onset and duration of effect of incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA in the treatment of glabellar frown lines: a randomized, double-blind study

Abstract

BackgroundThree botulinum neurotoxin type A preparations (incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA) are widely approved in Europe and in the US for the treatment of glabellar frown lines. The purpose of this study was to determine and compare the time to onset and duration of treatment effect of incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA for the treatment of glabellar frown lines.Subjects and methodsSubjects aged 20–60 years with moderate to severe glabellar frown lines received one treatment of either 21 units (U) incobotulinumtoxinA, 21 U onabotulinumtoxinA, or 63 U abobotulinumtoxinA. Assessments were made over a period of 180 days. Onset of treatment effect was defined as the day that the observer noted a decrease in glabellar muscle activity compared with baseline photographs and videos. Duration of treatment effect was defined as the time until glabellar muscle action returned to the baseline level. Analyses were performed using a Weibull log(T) regression model.ResultsThe study enrolled 180 subjects; 60 per group. For all three products, onset of treatment effect occurred earlier in female subjects compared to male subjects. For both sexes, a significantly earlier time to onset of treatment effect was seen for incobotulinumtoxinA compared to onabotulinumtoxinA and abobotulinumtoxinA; in female subjects these times were 3.02 days, 5.29 days, and 5.32 days, respectively. The duration of treatment effect was longer for incobotulinumtoxinA compared to onabotulinumtoxinA and abobotulinumtoxinA; for all products, treatment effect duration was longer in females than in males. Time to onset was not a predictor of treatment duration.ConclusionIncobotulinumtoxinA demonstrated a more rapid onset and a longer duration of treatment effect than onabotulinumtoxinA (1:1 dose ratio) and abobotulinumtoxinA (1:3 dose ratio). Onset of effect was faster and duration of effect was longer in female subjects compared to male subjects.

IncobotulinumtoxinA for Migraine: A Retrospective Case Series

“…10 In addition, a recent analysis suggested that incobotulinumtoxinA may have a more rapid onset and longer duration of action compared with onabotulinumtoxinA. 11 The goal of the present case report was to provide initial data regarding an alternative botulinum agent in the treatment of chronic migraine.…”

Technical Considerations for Filler and Neuromodulator Refinements

“…Despite these distinctions and anecdotal observations that these products are not interchangeable, clinical studies remain inadequate and have failed to demonstrate consistent substantive differences between neurotoxins. 6–22 Limited data suggest that incobotulinumtoxinA has a more rapid onset and longer duration, 10 whereas abobotulinumtoxinA has greater spread, 11 and onabotulinumtoxinA has greater strain reduction. 12 Importantly, all neurotoxins elicit similar positive effects on patients’ self-perception of appearance.…”

Efficacy and patient satisfaction with incobotulinumtoxinA for the treatment of glabellar frown lines

“…(1) IncobotulinumtoxinA (marketed under the trademark Xeomin®) has been shown to be effective for the treatment of glabellar frown lines (GFLs). (3)(4)(5)(6) It contains only the active neurotoxin and none of the complexing proteins commonly found in other BoNT/A products. As these complexing proteins are not required for the neurotoxin activity, incobotulinumtoxinA has a higher specific biologic activity in each dose.…”

“…(7) Thus, the onset of treatment effect is more rapid for incobotulinumtoxinA as compared to other variants of BoNT/A. (6) A multicentre European study found that overall treatment satisfaction in using incobotulinumtoxinA specifically for GFLs was high among physicians and patients. (3) The drug was also well tolerated and had a longer duration of effect, permitting a gap of five months or more between injections.…”

“…(3) The drug was also well tolerated and had a longer duration of effect, permitting a gap of five months or more between injections. (3,6,8) However, reported data from clinical trials has typically been obtained from a week post injection (9) to as long as 30 days after treatment, (4) as the focus was often on efficacy rather than the onset of effect. As a result, the efficacy of incobotulinumtoxinA for the treatment of GFLs has been widely published, but its rapid onset of effect is less well documented.…”