Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Feb;47(1):365-377.
doi: 10.1007/s00266-022-03018-y. Epub 2022 Sep 12.

Efficacy and Safety of Botulinum Toxin Type A for Treatment of Glabellar Lines: A Network Meta-Analysis of Randomized Controlled Trials

Xue Li  1 , Changlin Sui  1 , Xiujuan Xia #  2 , Xianjin Chen #  3
Affiliations
Review

Efficacy and Safety of Botulinum Toxin Type A for Treatment of Glabellar Lines: A Network Meta-Analysis of Randomized Controlled Trials

Xue Li et al. Aesthetic Plast Surg. 2023 Feb.

Abstract

Background: Botulinum toxin type A (BoNT/A) has been used in aesthetic applications worldwide, including glabellar lines. Currently, four BoNT/A preparations were approved for the improvement of moderate-to-severe glabellar lines: onabotulinumtoxinA, abobotulinumtoxinA, incobotulinumtoxinA, and prabotulinumtoxinA. DaxibotulinumtoxinA is a new form of BoNT/A drug that is developed in clinical application. We performed this network meta-analysis (NMA) to assess the efficacy and safety of all these different BoNT/A formulations for treating glabellar lines.

Methods: The investigators searched randomized controlled trials (RCTs) using the Medical Subject Headings (MeSH) terms "botulinum toxin" and "glabellar lines." We searched the relevant studies in electronic databases as following: PubMed, Elsevier, EMBASE and the Cochrane Library. The end points included the percentage of subjects with a glabellar line severity (GLS) score of none (0) or mild (1), and the percentage of subjects achieving ≥ 1-point and 2-point improvement in glabellar line severity at maximum frown at approximately month 1 by the investigators' assessment.

Results: All formulations of BoNT/A were far superior to placebo in efficacy. DaxibotulinumtoxinA was the only treatment that significantly increased the proportion of subjects achieving ≥ 1 point improvement in GLS score compared with other BoNT/A formulations. Moreover, daxibotulinumtoxinA was ranked the highest for the proportion of subjects achieving ≥ 2-point improvement in GLS score. No significant differences were revealed for the incidence of any adverse events (AEs) that related to treatment or drug among all BoNT/A preparations.

Conclusion: The overall results of this NMA suggested that daxibotulinumtoxinA is a new BoNT/A preparation that may be not only more effective but also well-tolerated for the treatment of glabellar lines.

Level of evidence i: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Botulinum toxin type A (BoNT/A); Glabellar lines (GL); Network meta-analysis (NMA).

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

References

    1. Kim BJ, Kwon HH, Park SY et al (2014) Double-blind, randomized non-inferiority trial of a novel botulinum toxin A processed from the strain CBFC26, compared with onabotulinumtoxin A in the treatment of glabellar lines. J Eur Acad Dermatol Venereol 28(12):1761–1767 - DOI - PubMed
    1. Kawashima M, Harii K, Horiuchi Y et al (2020) Safety, efficacy, and patient satisfaction with onabotulinumtoxin A for the treatment of upper facial lines in Japanese subjects. Dermatol Surg 46(4):483–490 - DOI - PubMed
    1. William Hanke C, Narins RS, Brandt F et al (2013) A randomized, placebo-controlled, double-blind phase iii trial investigating the efficacy and safety of incobotulinumtoxin A in the treatment of glabellar frown lines using a stringent composite endpoint. Dermatol Surg 39(6):891–899 - DOI - PubMed
    1. Yoo KH, Lee YW, Lee JS et al (2021) Efficacy and safety of a new botulinum toxin (HU-014) versus existing onabotulinumtoxin A in subjects with moderate to severe glabellar lines. Dermatol Surg 47(3):e91–e96 - PubMed
    1. Gubanova E, Haddad TM, Bergerova Y et al (2018) Assessment of subject and physician satisfaction after long-term treatment of glabellar lines with AbobotulinumtoxinA (Dysport((R))/Azzalure((R))): primary results of the APPEAL noninterventional study. Aesthetic Plast Surg 42(6):1672–1680 - DOI - PubMed - PMC

Substances