Comparing Ready-to-Use and Powder AbobotulinumtoxinA for Glabellar Lines: A Randomized, Controlled, Triple-Blinded Clinical Trial

Abstract

Background: Botulinum toxin A (BoNT-A) is the most used procedure to treat glabellar lines; however, limited data exist about the effectiveness of ready-to-use BoNT-A (RTUaboBoNT-A) for this indication. Aims: This study compared the efficacy, durability, and safety of RTUaboBoNT-A for moderate and severe glabellar wrinkles. Methods: This randomized triple-blinded trial included 38 male volunteers aged between 25 and 50 years. Participants were randomly divided into two groups: abobotulinumtoxinA (aboBoNT-A, n = 18) and RTUaboBoNT-A (n = 20). Groups received 10 U for procerus muscle and 20 U for the corrugator muscle. Assessed variables included, electromyography activity (EMG), Merz 5-point glabellar lines scale, FACE-Q appraisal for lines between the eyebrows and Visual Analogue Scale for pain intensity. Assessments were performed before and 1, 2, 3, and 4 months after injections. For differences in EMG and satisfaction scores, the two-way repeated-measures ANOVA and Bonferroni's post hoc analyses were conducted. Wrinkle severity scores were analyzed with the chi-squared test. Results: Inter-group comparisons revealed no significant differences in EMG scores in all assessed periods for the corrugator supercili (p = 0.11) and the procerus muscles (p = 0.93); for severity of glabellar lines, no significant differences were also found in all follow-ups for rest (p = 0.737) and contracted position (p = 0.390), as well as for satisfaction with the treatments. However, the RTUaboBoNT-A group presented higher levels of pain intensity during the injection procedure (p = 0.01). Conclusion: The RTUaboBoNT-A and aboBoNT-A are comparable in efficacy, durability, and safety.