title: A prospective, randomized, parallel group study analyzing the effect of BTX-A (Botox) and nonanimal sourced hyaluronic acid (NASHA, Restylane) in combination compared with NASHA (Restylane) alone in severe glabellar rhytides in adult female subjects: treatment of severe glabellar rhytides with a hyaluronic acid derivative compared with the derivative and BTX-A.
abstract: BACKGROUND
  Over the past 15 years, BTX-A has become the standard treatment for dynamic glabellar furrowing. Some individuals have resting glabellar rhytides that are sufficiently deep that they respond poorly to BTX-A alone.
  
  
  OBJECTIVE
  To compare the efficacy of BTX-A combined with intradermal nonanimal stabilized hyaluronic acid (NASHA) with the efficacy of NASHA alone in females with moderate to severe glabellar rhytides.
  
  
  METHODS
  This was a prospective randomized study of 38 subjects with moderate to severe glabellar rhytides. Half of the subjects were treated with BTX-A and NASHA and the other half with NASHA alone. Their response was assessed clinically and photographically.
  
  
  RESULTS
  By comparison with the NASHA-alone group, the BTX-A plus NASHA group showed a better response both at rest and on maximum frown, and this response was maintained for longer. The median time for return to preinjection furrow status occurred at 18 weeks in the NASHA-alone group compared with 32 weeks for the BTX-A plus NASHA group.
authors.affiliation: Department of Ophthalmology, University of British Columbia, Vancouver, British Columbia, Canada. drjean@carruthers.net
authors.forename: Jean
authors.initials: J
authors.lastname: Carruthers
authors.forename: Alastair
authors.initials: A
authors.lastname: Carruthers
mesh_terms: D000328:Adult; D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D005546:Forehead; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D015595:Skin Aging / Q000187:drug effects*; D016896:Treatment Outcome
chemical_list: D006820:Hyaluronic Acid; D019274:Botulinum Toxins, Type A; C445361:Restylane