Dosing, efficacy and safety plus the use of computerized photography for botulinum toxins type A for upper facial lines.
BACKGROUND
Several studies confirm that botulinum toxins type A (BTX-A) are effective for reducing facial lines caused by hyperactive muscles. Two different commercial types of BTX-A currently available are BTX-A-1 (Botox) and BTX-A-2 (Dysport). This paper reports further comparison of dosing, efficacy and safety.


METHODS
Sites treated: glabellar, horizontal forehead lines and crow's feet. Different dilutions and dosages were studied with BTX-A-1 and BTX-A-2. The reduction of facial lines was evaluated by investigators and patients. Computerized photographic numerical assessment was also studied in determining the efficacy of BTX-A for crow's feet lines.


RESULTS
Study 1: Injecting glabellar lines at doses of BTX-A-1 (30 units) and BTX-A-2 (75 units) (2.5:1 ratio BTX-A2:BTX-A1) showed similar efficacy. Study 2: BTX-A-2 (256 units total) was significantly more effective than BTX-A-1 (64 units total) (i.e. a dose ratio of 4:1) for upper face lines. No differences in the side-effect profiles between the two toxins were observed in either study. Study 3: A computerized photographic numerical assay was an objective assessment of crow's feet severity. Using a dose ratio of BTX-A-2 to BTX-A-1 of 3:1 showed a trend towards BTX-A-2 superiority.


CONCLUSIONS
Two different botulinum toxins type A were shown to be effective and safe for hyperfunctional facial lines. The choice of dose, dilution and placement is critical for each individual toxin. Computerized photography gave numerical severity scores of crow's feet severity.
Cranley Clinic, London, UK. cranley@cranleyclinic.com
Nicholas J
NJ
Lowe
Aadarsh
A
Shah
Philippa L
PL
Lowe
Rickie
R
Patnaik
D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005152:Facial Muscles / Q000187:drug effects*; D005260:Female; D005546:Forehead; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017060:Patient Satisfaction; D012060:Rejuvenation; D015595:Skin Aging / Q000187:drug effects*; D016896:Treatment Outcome; D055815:Young Adult
C586826:DWP450; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A