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Yoo KH, Park SJ, Han HS, Won CH, Lee YW, Kim BJ. Randomized, double-blind, active-controlled, multicentre, phase III clinical trial with two stages to assess the safety and efficacy of letibotulinum toxin a vs. onabotulinum toxin a for subjects with moderate to severe crow's feet. J Eur Acad Dermatol Venereol 2021; 35:1587-1594. [PMID: 33721365 DOI: 10.1111/jdv.17217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/24/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Letibotulinum toxin A (LeBA) was approved by the Ministry of Food and Drug Safety (known as the Korea Food & Drug Administration) for cosmetic indications in 2012. However, the efficacy and safety of this newly introduced LeBA have not been investigated in crow's feet lines (CFL) treatment and standardization before its universal use. OBJECTIVE The aim of this multicentre, double-blind, randomized, parallel, active-controlled Phase III clinical trial with two stages (ClinicalTrials.gov identifier: NCT03408236) was to investigate the non-inferiority of LeBA vs. the existing onabotulinum toxin A (OnBA) for the treatment of CFL. METHODS A total of 240 subjects were randomized to either the test (LeBA) or control (OnBA) group. At the baseline and at weeks 4 while maximum smiling (primary efficacy assessment), 8, 12 and 16, investigator's on-site evaluation, independent evaluator, evaluation by the subjects, subjects' satisfaction assessment and safety assessment were performed. RESULTS At week 4, the response rate of primary efficacy assessment was 69.75% and 68.33% in the test (LeBA) and control (OnBA) groups, respectively, without a significant difference. Other minor secondary evaluation results showed significant differences suggesting that LeBA offered better improvement than OnBA, but the overall results did not show significant differences between the two groups. CONCLUSION This study showed that LeBA was as effective and safe as OnBA for the treatment of CFL at the same doses.
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Affiliation(s)
- K H Yoo
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - S J Park
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - H S Han
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - C H Won
- Department of Dermatology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea
| | - Y W Lee
- Department of Dermatology, College of Medicine, Konkuk University Hospital, Seoul, Korea
| | - B J Kim
- Department of Dermatology, College of Medicine, Chung-Ang University Hospital, Seoul, Korea
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Kapoor KM, Chatrath V, Anand C, Shetty R, Chhabra C, Singh K, Vedamurthy M, Pai J, Sthalekar B, Sheth R. Consensus Recommendations for Treatment Strategies in Indians Using Botulinum Toxin and Hyaluronic Acid Fillers. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2017; 5:e1574. [PMID: 29632761 PMCID: PMC5889450 DOI: 10.1097/gox.0000000000001574] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 09/26/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Indians constitute one of the largest population groups in the world. Facial anthropometry, morphology, and age-related changes in Indians differ from those of other ethnic groups, necessitating a good understanding of their facial structure and the required aesthetic treatment strategies. However, published recommendations specific to Indians are few, particularly regarding combination treatment. METHODS The Indian Facial Aesthetics Expert Group (19 dermatologists, plastic surgeons, and aesthetic physicians with a mean 15.5 years' aesthetic treatment experience) met to develop consensus recommendations for the cosmetic facial use of botulinum toxin and hyaluronic acid fillers, alone and in combination, in Indians. Treatment strategies and dosage recommendations (agreed by ≥ 75% of the group) were based on results of a premeeting survey, peer-reviewed literature, and the experts' clinical experience. RESULTS The need for combination treatment increases with age. Tear trough deficiency is the most common midface indication in Indian women aged 20-40 years. In older women, malar volume loss and jowls are the most common aesthetic concerns. Excess medial soft tissue on a relatively smaller midface precedes age-related sagging. Hence, in older Indians, fillers should be used peripherally to achieve lift and conservatively in the medial zones to avoid adding bulk medially. The shorter, wider lower face requires 3-dimensional correction, including chin augmentation, to achieve increased facial height and the oval shape desired by most Indian women. CONCLUSIONS These recommendations give physicians treating Indians worldwide a better understanding of their unique facial characteristics and provide treatment strategies to achieve optimal aesthetic outcomes.
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Affiliation(s)
- Krishan Mohan Kapoor
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Vandana Chatrath
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Chytra Anand
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Rashmi Shetty
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Chiranjiv Chhabra
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Kuldeep Singh
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Maya Vedamurthy
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Jamuna Pai
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Bindu Sthalekar
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
| | - Rekha Sheth
- From the Anticlock Clinic, Chandigarh, India.; Department of Plastic Surgery, Fortis Hospital, Mohali, India; Delhi Dermatology Group, New Delhi, India; Kosmoderma Skin & Hair Clinics, Bangalore, Chennai, Hyderabad, India; RA Skin and Aesthetics, Mumbai, India; Skin Alive Clinics, New Delhi, India; Department of Plastic, Reconstructive & Aesthetic Surgery, Indraprastha Apollo Hospital, New Delhi, India; RSV Skin Clinic, Chennai, India; Apollo Hospital, Chennai, India; Dr Jamuna Pai’s Skin Lab, Mumbai, Pune, New Delhi, India; Skin Smart Solutions Clinic, Mumbai, India; Skin & Hair Clinics LLP, Mumbai, India
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