A Phase III Clinical Study of the Efficacy and Safety of Botulinum Toxin Type A (MASPORT) with DYSPORT for the Treatment of Glabellar Lines

BACKGROUND

Botulinum toxin type A is a widely used treatment of facial wrinkles. The objective of this study was to compare the efficacy and safety of a new botulinum toxin type A (Masport [abobotulinum toxin A], MasoonDarou Co) with DYSPORT® for the treatment of glabellar lines.

METHODS

262 subjects with moderate-to-severe glabellar lines received either a fixed dose of 50 units of MASPORT® or DYSPORT® (Ipsen Company, England). Subjects were followed up at 14, 30, 60, 90 and 120 days after injection. Efficacy was assessed by investigator at maximum frown and rest and also by Subject Global Assessment of Change (SGA). The responders were defined as persons with +2 grade improvement from baseline for both investigator and patient assessment. The occurrence and duration of adverse effects were recorded up throughout the study.

RESULTS

According to the investigator evaluations, the responder rate at maximum frown were 94.5% for MASPORT and 95.6% for DYSPORT group on day 30 and at rest were 85.45% and 85.68% for MASPORT and DYSPORT group, respectively. According to the subject self-assessment, the proportion of responders in MASPORT group at day 30 was 95.28% versus 97.04% for DYSPORT group. No serious drug related adverse effect was recorded in either study groups, and the rates of adverse effects were similar for both groups.

CONCLUSION

Abobotulinum toxin A [MASPORT] is equally safe and effective as commercial product [DYSPORT] for the treatment of glabellar lines with the dose of 50 units, up to 120 days.

LEVEL OF EVIDENCE I

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Genito-thyroid index (Neutrophil-to-lymphocyte ratio) and basophils as predictors of left ventricular remodeling after acute myocardial infarction

Funding Acknowledgements

Type of funding sources: None.

Background

The neutrophil-to-lymphocyte ratio (NLR) is associated with inflammation. The theory of Endobiogeny is a complex systems theory of physiology that evaluates the relationship between biomarkers and endocrine management of adaptation response. NLR is referred to in this system as the "Genito-thyroid index" (GTI) due to the roles of estrogen and thyroid hormones in immune response. Basophils correlate with worse outcomes in critical illness and are stimulated by ACTH when there is delayed cortisol excretion from the adrenal cortex. These biomarkers are routinely obtained after acute myocardial infarction (AMI), but their relationship to AMI and left ventricular ejection fraction (LVEF) have not been established.

Purpose

The aim of this study was to assess the relationship between the GTI and %Basophils to LVEF in first time AMI.

Methods

This prospective study included 52 consecutive patients diagnosed with AMI, admitted to the intensive care unit of our university hospital from April 2017 to November 2017. Percent neutrophils, lymphocytes and basophils were determined on admission (GTI1, Basophil1) and before discharge (GTI2, Basophil2). Diagnostic coronary angiography and percutaneous coronary intervention (PCI) was performed for all patients. All patients underwent transthoracic echocardiography within hospitalization period (LVEF1) and after 6 months (LVEF2) during follow up period. Echocardiography was performed using a Philips machine. LV function was assessed by the measurement of EF using the biplane Simpson’s disc summation method through QLAB ultrasound cardiac analysis on apical two- and four-chamber views. Statistical analyses were performed using the SPSS 20.0 software. Spearman’s rank correlation coefficient was used to examine the relationship between different variables. A p-value <0.05 was considered statistically significant.

Results

Study population mean age was 63.9 ± 11.6 years. Mean GTI1 was 4.5 ± 2.8 (1.5-2.5). Mean GTI2 was 2.8 ± 1.4. Δ GTI1-2 significantly and positively correlated with Δ LVEF1-2 (r = 0.380, p = 0.019). Mean Basophils1 was 0.3 ± 0.2% (<0.2%). Mean Basophil2 was 0.4 ± 0.3%. Δ Basophil1-2 positively correlated with Δ LVEF 1-2 (r = 0.435, p = 0.015). No significant correlation was found between GTI1 and Δ LVEF1-2 (r = 0.137, p = 0.332), or Basophil1 and Δ LVEF1-2 (r = -0.186, p = 0.196).

Conclusion

Admission values of GTI and basophils, while both elevated did not correlate with LVEF1-2. However, Δ GTI1-2 and Δ basophils1-2 did. From this we conclude that relative recovery of the systemic response to AMI is more significative than initial response and affects myocardial recovery. Monitoring GTI and basophils is commonly performed and inexpensive. It reflects a role of the endocrine system not before investigated in myocardial recovery post-AMI. It may be useful for identifying patients at risk of poor LVEF post-AMI.

Comparison of UVA Protection Factor Measurement Protocols

Background

In the past, it was taught that UVA wavelengths (320- 400nm) only plays a major role in skin aging but recently the scientific researches also show that UVA cause cancerous keratinocyte cells in deep layer of the epidermis. Therefore, the protective ability of the product against UVA is important in addition to protection against UVB rays. The UVA protective factor (UVA-PF) is used to evaluate the effectiveness of sunscreen products against UVA rays. This study aims to review and compare all outstanding protocols in the field of UVA-PF measurement and finally the introduction of the best method of measuring UVA-PF based on the further benefits.

Materials and Methods

Four standards including ISO 24443 (AS/NZS 2604: 2012 recommended approach), CEN 2006, FDA 2007 and FDA 2011 are selected.

Results

In order to measure UVA-PF with in vivo method, two standards of CEN 2006 and FDA 2007 recommended persistent pigment darkening (PPD) method. Although the general principle of both is similar, there are some differences in detail. For in vitro measurement of UVA-PF, CEN and FDA 2011 standards use critical wavelengths. FDA 2007 introduces the modified Diffey fraction, and ISO 24443 standard meets the UVA-PF measurement in a manner that is consistent with PPD.

Conclusion

Finally, this review discussed the comparison of all in vitro and in vivo UVA-PF measurement standards and provided information in the form of texts and tables to move towards the creation of an integrated standard. Since in vitro methods of UVA-PF measurement are not reproducible due to differences in test conditions, it may be concluded that the in vivo PPD method is a more suitable option.