Skip to main content

Advertisement

Log in

Comparison of the spread of three botulinum toxin type A preparations

  • Original Paper
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Botulinum toxins are frequently used in esthetics to improve the appearance of facial wrinkles. In this setting, precise localization of the neurotoxin is required to produce the desired clinical effects. Unwanted effects can occur if the neurotoxin diffuses into untargeted muscle. Therefore, a neurotoxin with low and predictable spread would be preferable for esthetic applications. The aim of this study was to investigate the spread of three approved botulinum toxin type A preparations, with and without complexing proteins, by measuring and comparing the size of the anhidrotic halos they produced following injection of equivalent doses in an identical volume into the forehead of patients. The results showed that incobotulinumtoxinA and onabotulinumtoxinA displayed comparable spread at 6 weeks (maximal area of anhidrosis within 6 weeks) and area under the effect curve (AUEC) over 6 months. However, abobotulinumtoxinA, when assuming a 1:2.5 injection volume ratio, produced a statistically significantly greater maximal area of anhidrosis within 6 weeks and AUEC over 6 months compared with incobotulinumtoxinA. All preparations were well tolerated. The results of this study demonstrate that incobotulinumtoxinA and onabotulinumtoxinA have comparable spread, while abobotulinumtoxinA has significantly greater spread than incobotulinumtoxinA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Ascher B, Zakine B, Kestemont P, Baspeyras M, Bougara A, Santini J (2004) A multicenter, randomized, double-blind, placebo-controlled study of efficacy and safety of 3 doses of botulinum toxin A in the treatment of glabellar lines. J Am Acad Dermatol 51:223–233

    Article  PubMed  Google Scholar 

  2. Ascher B, Rzany BJ, Grover R (2009) Efficacy and safety of botulinum toxin type A in the treatment of lateral crow’s feet: double-blind, placebo-controlled, dose-ranging study. Dermatol Surg 35:1478–1486

    Article  PubMed  CAS  Google Scholar 

  3. Benecke R, Jost W, Kanovsky P, Ruzicka E, Comes G, Grafe S (2005) A new botulinum toxin type A free of complexing proteins for treatment of cervical dystonia. Neurology 64:1949–1951

    Article  PubMed  CAS  Google Scholar 

  4. Carruthers A, Kiene K, Carruthers J (1996) Botulinum A exotoxin use in clinical dermatology. J Am Acad Dermatol 34:788–797

    Article  PubMed  CAS  Google Scholar 

  5. Carruthers A, Carruthers J (2008) Botulinum toxin products overview. Skin Ther Lett 13:1–5

    CAS  Google Scholar 

  6. Carruthers JA, Lowe NJ, Menter MA, Gibson J, Nordquist M, Mordaunt J, Walker P, Eadie N (2002) A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. J Am Acad Dermatol 46:840–849

    Article  PubMed  Google Scholar 

  7. Cliff SH, Judodihardjo H, Eltringham E (2008) Different formulations of botulinum toxin type A have different migration characteristics: a double-blind, randomized study. J Cosmet Dermatol 7:50–54

    Article  PubMed  Google Scholar 

  8. de Almeida AT, De Boulle KJ (2007) Diffusion characteristics of botulinum neurotoxin products and their clinical significance in cosmetic applications. J Cosmet Laser Ther 9(Suppl 1):17–22

    Article  PubMed  Google Scholar 

  9. De Boulle K, Fragien S, Sommer B, Glogau R (2010) Treating glabellar lines with botulinum toxin type-A-hemagglutinin complex: a review of the science, the clinical data, and patient satisfaction. Clin Interv Aging 5:101–118

    Article  PubMed  Google Scholar 

  10. De Maio M, Rzany B (2007) Botulinum toxin in aesthetic medicine. Springer, Heidelberg, Germany

    Book  Google Scholar 

  11. Dressler D, Benecke R (2007) Pharmacology of therapeutic botulinum toxin preparations. Disabil Rehabil 29:1761–1768

    Article  PubMed  Google Scholar 

  12. Eisele KH, Fink K, Vey M, Taylor HV (2011) Studies on the dissociation of botulinum neurotoxin type A complexes. Toxicon 57:555–565

    Article  PubMed  CAS  Google Scholar 

  13. Hexsel D, Dal’Forno T, Hexsel C, Do Prado DZ, Lima MM (2008) A randomized pilot study comparing the action halos of two commercial preparations of botulinum toxin type A. Dermatol Sur 34:52–59

    Article  CAS  Google Scholar 

  14. Hsu TS, Dover JS, Arndt KA (2004) Effect of volume and concentration on the diffusion of botulinum exotoxin A. Arch Dermatol 140:1351–1354

    Article  PubMed  CAS  Google Scholar 

  15. Inoue K, Fujinaga Y, Watanabe T, Ohyama T, Takeshi K, Moriishi K, Nakajima H, Inoue K, Oguma K (1996) Molecular composition of Clostridium botulinum type A progenitor toxins. Infect Immun 64:1589–1594

    PubMed  CAS  Google Scholar 

  16. Jost WH, Kohl A, Brinkmann S, Comes G (2005) Efficacy and tolerability of a botulinum toxin type A free of complexing proteins (NT 201) compared with commercially available botulinum toxin type A (Botox®) in healthy volunteers. J Neural Transm 112:905–913

    Article  PubMed  CAS  Google Scholar 

  17. Kanovský P, Slawek J, Denes Z, Platz T, Sassin I, Comes G, Grafe S (2009) Efficacy and safety of botulinum neurotoxin NT 201 in poststroke upper limb spasticity. Clin Neuropharmacol 32:259–265

    Article  PubMed  Google Scholar 

  18. Karsai S, Raulin C (2009) Current evidence on the unit equivalence of different botulinum neurotoxin A formulations and recommendations for clinical practice in dermatology. Dermatol Surg 35:1–8

    Article  PubMed  CAS  Google Scholar 

  19. Klein A, Carruthers A, Fagien S, Lowe NJ (2008) Comparisons among botulinum toxins: an evidence-based review. Plast Reconstr Surg 121:413e–422e

    Article  PubMed  Google Scholar 

  20. Lowe NJ, Ascher B, Heckmann M, Kumar C, Fraczek S, Eadie N (2005) Double-blind, randomised, placebo-controlled, dose-response study of the safety and efficacy of botulinum toxin type A in subjects with crow’s feet. Dermatol Surg 31:257–262

    Article  PubMed  CAS  Google Scholar 

  21. Minor V (1928) Ein neues verfahren zu der klinischen untersuchung der schweiβabsonderung. Deutsch Z Nervenhlk 101:302–308

    Article  Google Scholar 

  22. Monheit G, Carruthers A, Brandt F, Rand R (2007) A randomised, double-blind, placebo-controlled study of botulinum toxin type A for the treatment of glabellar lines: determination of optimal dose. Dermatol Surg 33:S51–S59

    Article  PubMed  CAS  Google Scholar 

  23. Roggenkämper P, Jost W, Bihari K, Comes G, Grafe S (2006) Efficacy and safety of a new botulinum toxin type A free of complexing proteins in the treatment of blepharospasm. J Neural Transm 113:303–312

    Article  PubMed  Google Scholar 

  24. Trindade de Almeida AR, Marques E, de Almeida J, Cunha T, Boraso R (2007) Pilot study comparing the diffusion of two formulations of botulinum toxin type A in patients with forehead hyperhidrosis. Dermatol Surg 33:S37–S43

    Article  PubMed  CAS  Google Scholar 

  25. Wohlfarth K, Muller C, Sassin I, Comes G, Grafe S (2007) Neurophysiological double-blind trial of a botulinum neurotoxin type A free of complexing proteins. Clin Neuropharmacol 30:86–94

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors wish to thank Ulrike Beimel and Luciano Zoppelli. The study was sponsored by Merz Pharmaceuticals GmbH. Editorial assistance was provided by Ogilvy 4D and funding was provided by Merz Pharmaceuticals GmbH.

Conflict of interest

University of Hamburg, Division of Cosmetic Sciences (Head: Professor Martina Kerscher) collaborates with Merz Pharmaceuticals GmbH, Q-Med AB, Laboratoires Pierre Fabre SA and Kythera on several clinical studies. Dr Walter Wigger-Alberti has no financial relationship with Merz Pharmaceuticals GmbH and declares that he has no conflict of interest. Drs S Roll and A Becker are employees of Merz Pharmaceuticals GmbH, Germany.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Martina Kerscher.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kerscher, M., Roll, S., Becker, A. et al. Comparison of the spread of three botulinum toxin type A preparations. Arch Dermatol Res 304, 155–161 (2012). https://doi.org/10.1007/s00403-011-1179-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00403-011-1179-z

Keywords

Navigation