title: IncobotulinumtoxinA use in aesthetic indications in daily practice: a European multicenter, noninterventional, retrospective study.
abstract: OBJECTIVE
  To characterize utilization patterns and treatment satisfaction with incobotulinumtoxinA for aesthetic indications and assess adherence to the Summary of Product Characteristics.
  
  
  METHODS
  Data were collected retrospectively from physicians in Germany, France, and the UK regarding patients (n=638) treated with incobotulinumtoxinA for aesthetic indications. Data on indication, treatment interval, dose injected, physician and patient satisfaction, and adverse drug reactions were recorded according to routine daily practice.
  
  
  RESULTS
  Most patients (76.0%) received incobotulinumtoxinA for glabellar frown lines (GFL) and were given doses of ≤20 U. The majority of treatment intervals were 5 months or longer. Overall, 64.1% of patients were treated for off-label indications, sometimes in combination with treatment for GFL. The most frequently treated off-label indications were horizontal forehead lines (38.6%) and/or crow's feet (CF; 31.7%); for CF, >95% of injected doses were ≤24 U. In Germany, a smaller proportion of patients were given incobotulinumtoxinA treatment for CF (27.6%), compared with France (40.4%) and the UK (33.2%), although country-specific differences were less prominent when treatment cycle data for CF were examined. Treatment satisfaction among physicians and patients (overall, and for GFL specifically) was very high, with excellent tolerability and only one mild adverse drug reaction reported.
  
  
  CONCLUSIONS
  In daily practice, incobotulinumtoxinA is mainly used for GFL; however, its use for CF and horizontal forehead lines (often in combination with GFL) is relatively common. Treatment satisfaction across aesthetic indications is high, and incobotulinumtoxinA is well tolerated, with time intervals of 5 months or longer between injections in the majority of cases. When considering factors such as dose and treatment interval, adherence to the Summary of Product Characteristics when treating GFL in daily practice is good. These results support previous reports that incobotulinumtoxinA is an effective treatment for GFL, with an excellent safety profile. Furthermore, incobotulinumtoxinA may display efficacy and tolerability in other indications.
authors.affiliation: Private Practice, Munich, Germany.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pavicic
authors.affiliation: Dr. Prager & Partner, Derma-Hamburg, Hamburg, Germany.
authors.forename: Welf
authors.initials: W
authors.lastname: Prager
authors.affiliation: Private Practice Clinic of Esthetic Surgery, MediCenter Munich-Solln, Munich, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Klöppel
authors.affiliation: Clinetix Rejuvenation, Glasgow, Scotland, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Ravichandran
authors.affiliation: Department of Ophthalmology, Adolphe Rothschild Ophthalmological Foundation, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Galatoire
keywords: NT 201; Xeomin®/Xeomeen®/Bocouture®/XEOMIN Cosmetic™; crow’s feet; daily practice; free from complexing proteins; glabellar frown lines; incobotulinumtoxinA; retrospective
references.citation: Clin Interv Aging. 2013;8:449-56
references.pmid: 23650444
references.citation: J Drugs Dermatol. 2013 Dec;12(12):1434-46
references.pmid: 24301246
references.citation: J Drugs Dermatol. 2012 Feb;11(2):216-9
references.pmid: 22270205
references.citation: Dermatol Surg. 2013 Apr;39(4):551-8
references.pmid: 23379292
references.citation: J Am Acad Dermatol. 2004 Aug;51(2):223-33
references.pmid: 15280841
references.citation: Disabil Rehabil. 2007 Dec 15;29(23):1761-8
references.pmid: 18033601
references.citation: Drugs R D. 2010;10(2):67-73
references.pmid: 20698714
references.citation: Dermatol Surg. 2010 Dec;36 Suppl 4:2155-60
references.pmid: 21134046
references.citation: Clin Cosmet Investig Dermatol. 2012;5:53-8
references.pmid: 22791996
references.citation: J Dermatolog Treat. 2014 Aug;25(4):326-30
references.pmid: 23356833
references.citation: Dermatol Surg. 2013 Jun;39(6):891-9
references.pmid: 23506308
references.citation: Dermatol Surg. 2013 Mar;39(3 Pt 2):510-25
references.pmid: 23458295
references.citation: J Am Acad Dermatol. 2009 Jun;60(6):972-9
references.pmid: 19467368
references.citation: J Drugs Dermatol. 2013 Dec;12(12):1461-6
references.pmid: 24301249
references.citation: Acta Derm Venereol. 2014 Jan;94(1):32-7
references.pmid: 23975053
references.citation: J Eur Acad Dermatol Venereol. 2010 Nov;24(11):1278-84
references.pmid: 20337830
references.citation: J Clin Pharm Ther. 2007 Aug;32(4):387-402
references.pmid: 17635341
references.citation: Plast Reconstr Surg. 2003 Oct;112(5 Suppl):125S-126S
references.pmid: 14504493
references.citation: Clin Pharmacol. 2013;5:39-52
references.pmid: 23516136
references.citation: Plast Reconstr Surg. 2003 Sep 15;112(4):1089-98
references.pmid: 12973229
references.citation: J Am Acad Dermatol. 2002 Jun;46(6):840-9
references.pmid: 12063480
references.citation: Dermatol Surg. 2010 Dec;36 Suppl 4:2146-54
references.pmid: 21134045
references.citation: Plast Reconstr Surg. 2009 Nov;124(5):1619-29
references.pmid: 19584772
references.citation: J Dermatol Surg Oncol. 1992 Jan;18(1):17-21
references.pmid: 1740562
references.citation: Aesthet Surg J. 2013 Mar;33(1 Suppl):35S-40S
references.pmid: 23515197
references.citation: Clin Cosmet Investig Dermatol. 2013 Sep 24;6:211-9
references.pmid: 24098087