Abstract
Purpose :
There are many formulations of botulinumtoxinA (BoNT-A) that are used widely for cosmetic procedures. PrabotulinumtoxinA is one of the newer commercially available formulations of BoNT-A. The aim of this study was to investigate the efficacy, safety, and duration of prabotulinumtoxinA in comparison to onabotulinumtoxinA in a split-face clinical trial. Comparison of OnabotulinumtoxinA and Prabotulinumtoxin was performed to evaluate for a difference in efficacy, duration, and safety in the treatment of glabellar frown lines.
Methods :
A prospective, split-face, double-blinded randomized trial was performed to investigate the noninferiority of OnabotulinumtoxinA and PrabotulinumtoxinA. Twenty-two patients were randomized, with one side of the glabella receiving 8-10 units of OnabotulinumtoxinA and the other receiving 8-10 units of PrabotulinumtoxinA. Patients were surveyed regarding adverse events, day of onset, effectiveness at 3 weeks, and day of offset for each side. At 3 weeks, the injector evaluated effectiveness. Pre- and post-treatment photos at rest and maximal frown were graded by two masked oculoplastic surgeons on a validated five-point Merz scale. A Wilcoxon signed rank test was used for statistical analysis (α < 0.05).
Results :
No statistical difference was seen in adverse events (pain, bruising, and headache) as well as days to onset, days to offset, and duration. There was no difference in effectiveness at three weeks as graded by the patient and injector. On the Merz scale, a statistically significant difference was seen (p < 0.05) for both OnabotulinumtoxinA and PrabotulinumtoxinA in their pre and post treatment scores, but there was no statistically significant difference found between the two toxins when comparing change of Merz scores (p > 0.05). The interrater reliability between the two Oculofacial Plastic Surgeons who graded the photographs at baseline and 3 weeks was calculated to be 87%.
Conclusions :
No difference was seen between the two neurotoxins in effectiveness of treating glabellar lines, as well as in duration and safety. OnabotulinumtoxinA and PrabotulinumtoxinA are both effective in treating glabellar lines at frown and rest when evaluated three weeks post treatment at a total dose of 16-20 units of neurotoxin.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.