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Avtomonov V.Yu.

«Medea Esthetic» clinic

Razumovskaya E.A.

«Renaissance» clinic

Botulinum toxins in cosmetology: clarifications

Authors:

Avtomonov V.Yu., Razumovskaya E.A.

More about the authors

Journal: Russian Journal of Clinical Dermatology and Venereology. 2021;20(4): 135‑144

DOI: 10.17116/klinderma202120041135

Read: 5083 times

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Table of contents

BOTULINUM TOXINS IN COSMETOLOGY: CLARIFICATIONS
BOTULINUM TOXINS IN COSMETOLOGY: CLARIFICATIONS

To cite this article:

Avtomonov VYu, Razumovskaya EA. Botulinum toxins in cosmetology: clarifications. Russian Journal of Clinical Dermatology and Venereology. 2021;20(4):135‑144. (In Russ.)
https://doi.org/10.17116/klinderma202120041135

Подписка 2026 Клиническая дерматология и венерология (Russian Journal of Clinical Dermatology and Venereology)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

Currently, the most popular method for correcting wrinkles and other aesthetic problems of the facial skin is the use of botulinum toxin type A (BTA). At the same time, there are 7 drugs on the Russian market, which have significant differences in a number of parameters. The practitioner in the field of aesthetic medicine not only needs to have in-depth knowledge of facial anatomy and have the appropriate practical skills but also to understand the differences between the drugs containing BTA on the market. The purpose of the review is to systematize and present these differences for a better understanding by clinicians of the justification for the use of certain drugs. The advantages of individual BTA drugs are highlighted, in particular, when using onabotulinumtoxin A, a rapid onset of the therapeutic effect, limited migration of the drug from the injection point, long-term correction result, increased efficiency with repeated procedures, a high degree of patient satisfaction and low immunogenicity are noted. The main conclusion of the analysis of the presented literature is that products based on BTA are not interchangeable and when choosing a specific drug, one should first be guided by the principles of evidence.

Keywords:

glabellar wrinkles
botulinum toxin
interchangeability

Authors:

Avtomonov V.Yu.

«Medea Esthetic» clinic

Razumovskaya E.A.

«Renaissance» clinic

Received:

12.05.2021

Accepted:

11.06.2021

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References:

  1. Ambro BT, Wright RJ. Depression in the cosmetic surgery patient. Facial plastic surgery: FPS. 2010;26(4):333-338.  https://doi.org/10.1055/s-0030-1262309
  2. Grossbart TA, Sarwer DB. Psychosocial issues and their relevance to the cosmetic surgery patient. Seminars in Cutaneous Medicine and Surgery. 2003; 22(2):136-147.  https://doi.org/10.1053/sder.2003.50013
  3. Botox & Dermal Fillers can Reduce Depression, Anxiety and Improve Emotional Health: Revive Wellness Centers: Medical Aesthetics. Accessed April 19, 2021. https://www.revivecenter.com/blog/botox-dermal-fillers-can-reduce-depression-anxiety-and-improve-emotional-health
  4. Ilankovan V. Anatomy of ageing face. The British Journal of Oral & Maxillofacial Surgery. 2014;52(3):195-202.  https://doi.org/10.1016/j.bjoms.2013.11.013
  5. Singh G. Can we prevent skin aging? Indian Journal of Dermatology, Venereology and Leprology. 2009;75(5):447-451.  https://doi.org/10.4103/0378-6323.55386
  6. Kattimani V, Tiwari RVC, Gufran K., Wasan B, Shilpa PH, Khader AA. Botulinum Toxin Application in Facial Esthetics and Recent Treatment Indications (2013—2018). Journal of International Society of Preventive & Community Dentistry. 2019;9(2):99-105.  https://doi.org/10.4103/jispcd.JISPCD_430_18
  7. Huang W, Foster JA, Rogachefsky AS. Pharmacology of botulinum toxin. Journal of the American Academy of Dermatology. 2000;43(2):Pt1:249-259.  https://doi.org/10.1067/mjd.2000.105567
  8. Lam SM. The basic science of botulinum toxin. Facial Plastic Surgery Clinics of North America. 2003;11(4):431-438.  https://doi.org/10.1016/S1064-7406(03)00073-7
  9. Carruthers A, Carruthers J. Botulinum toxin type A. Journal of the American Academy of Dermatology. 2005;53(2):284-290.  https://doi.org/10.1016/j.jaad.2005.03.060
  10. Stupak HD, Maas CS. New procedures in facial plastic surgery using botulinum toxin A. Facial Plastic Surgery Clinics of North America. 2003;11(4): 515-520.  https://doi.org/10.1016/S1064-7406(03)00092-0
  11. Jandhyala R. Impact of botulinum toxin a on the quality of life of subjects following treatment of facial lines. The Journal of Clinical and Aesthetic Dermatology. 2013;6(9):41-45. 
  12. Gosudarstvennyi reestr lekarstvennykh sredstv. Accessed April 19, 2021. (In Russ.) https://grls.rosminzdrav.ru/Default.aspx
  13. Mendez-Eastman SK. BOTOX: a review. Plastic Surgical Nursing: Official Journal of the American Society of Plastic and Reconstructive Surgical Nurses. 2003;23(BOTOX, 2):64-69.  https://doi.org/10.1097/00006527-200323020-00006
  14. Andrade C. Bioequivalence of generic drugs: a simple explanation for a US Food and Drug Administration requirement. The Journal of Clinical Psychiatry. 2015;76(Bioequivalence of generic drugs, 6):e742-744.  https://doi.org/10.4088/JCP.15f10094
  15. Wolff-Holz E, Tiitso K, Vleminckx C, Weise M. Evolution of the EU Biosimilar Framework: Past and Future. BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy. 2019;33(Evolution of the EU Biosimilar Framework, 6):621-634.  https://doi.org/10.1007/s40259-019-00377-y
  16. Régnier S. What is the value of «me-too» drugs? Health Care Management Science. 2013;16(4):300-313.  https://doi.org/10.1007/s10729-013-9225-3
  17. Garattini S. Are me-too drugs justified? Journal of Nephrology. 1997;10(6): 283-294. 
  18. Kostrzewa, Richard, Archer, Trevor Current Topics in Neurotoxicity. ISSN: 2363-9563. Springer, 2020.
  19. Carruthers J, Carruthers A. The evolution of botulinum neurotoxin type A for cosmetic applications. Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology. 2007;9(3):186-192.  https://doi.org/10.1080/14764170701411470
  20. Naumann M, Boo LM, Ackerman AH, Gallagher CJ. Immunogenicity of botulinum toxins. Journal of Neural Transmission (Vienna, Austria: 1996). 2013;120(2):275-290.  https://doi.org/10.1007/s00702-012-0893-9
  21. Yoon S, Kurnasov O, Natarajan V, Hong M, Gudkov AV, Osterman AL, Wilson IA. Structural basis of TLR5-flagellin recognition and signaling. Science (New York, N.Y.). 2012;335(6070):859-864.  https://doi.org/10.1126/science.1215584
  22. Panjwani N, O’Keeffe R, Pickett A. Biochemical, functional and potency characteristics of type A botulinum toxin in clinical use. The Botulinum J. 2008;1(1):153-166.  https://doi.org/10.1504/TBJ.2008.018956
  23. Schantz EJ, Johnson EA. Dose standardisation of botulinum toxin. Lancet (London, England). 1990;335(8686):421.  https://doi.org/10.1016/0140-6736(90)90263-5
  24. Sesardic T. Bioassays for evaluation of medical products derived from bacterial toxins. Current Opinion in Microbiology 2012;15(3):310-316.  https://doi.org/10.1016/j.mib.2012.05.008
  25. Sesardic D, Leung T, Gaines Das R. Role for standards in assays of botulinum toxins: international collaborative study of three preparations of botulinum type A toxin. Biologicals: Journal of the International Association of Biological Standardization. 2003;31(Role for standards in assays of botulinum toxins, 4):265-276.  https://doi.org/10.1016/j.biologicals.2003.08.001
  26. Pharma commercial intelligence, news & analysis. Evaluate. Accessed April 12, 2021. https://www.evaluate.com/
  27. Nepal MR, Jeong TC. Alternative Methods for Testing Botulinum Toxin: Current Status and Future Perspectives. Biomolecules & Therapeutics. 2020; 28(Alternative Methods for Testing Botulinum Toxin, 4):302-310.  https://doi.org/10.4062/biomolther.2019.200
  28. Hambleton P. Clostridium botulinum toxins: a general review of involvement in disease, structure, mode of action and preparation for clinical use. Journal of Neurology. 1992;239(Clostridium botulinum toxins, 1):16-20.  https://doi.org/10.1007/BF00839205
  29. Botulinum toxin production method. Patent US7189541B2. S. Donovan. Claimed 07.12.05 ; published by 13.03.07. 
  30. Caballero ML, Krantz MS, Quirce S, Phillips EJ, Stone CA. Hidden Dangers: Recognizing Excipients as Potential Causes of Drug and Vaccine Hypersensitivity Reactions. The Journal of Allergy and Clinical Immunology: In Practice, 2021, Hidden Dangers.
  31. Kukreja RV, Singh BR. Comparative role of neurotoxin-associated proteins in the structural stability and endopeptidase activity of botulinum neurotoxin complex types A and E. Biochemistry. 2007;46(49):14316-14324. https://doi.org/10.1021/bi701564f
  32. Pirazzini M, Rossetto O, Eleopra R, Montecucco C. Botulinum Neurotoxins: Biology, Pharmacology, and Toxicology. Pharmacological Review., 2017; 69(Botulinum Neurotoxins, 2):200-235.  https://doi.org/10.1124/pr.116.012658
  33. Artemenko AR, Kurenkov AL, Belomestova KV. On the absence of interchangeability of botulinum toxin type A drugs. Meditsinskii Sove. 2015;5:112-123. (In Russ.).
  34. Cheng LW, Onisko B, Johnson EA, Reader JR, Griffey SM, Larson AE, Tepp WH, Stanker LH, Brandon DL, Carter JM. Effects of purification on the bioavailability of botulinum neurotoxin type A. Toxicology. 2008;249(2-3):123-129.  https://doi.org/10.1016/j.tox.2008.04.018
  35. Chen F, Kuziemko GM, Amersdorfer P, Wong C, Marks JD, Stevens RC. Antibody mapping to domains of botulinum neurotoxin serotype A in the complexed and uncomplexed forms. Infection and Immunity. 1997;65(5): 1626-1630. https://doi.org/10.1128/IAI.65.5.1626-1630.1997
  36. Cai S, Sarkar HK, Singh BR. Enhancement of the endopeptidase activity of botulinum neurotoxin by its associated proteins and dithiothreitol. Biochemistry. 1999;38(21):6903-6910. https://doi.org/10.1021/bi990086c
  37. Gary S, David R, Karen T, Roger AK, Terrence H. Characterization of time-dependent enzymatic profiles under various liquid conditions for 150 and 900kDa botulinum Type-A neurotoxins. Toxicon. 2008;51:21. 
  38. Gu S, Rumpel S, Zhou J, Strotmeier J, Bigalke H, Perry K, Shoemaker CB, Rummel A, Jin R. Botulinum neurotoxin is shielded by NTNHA in an interlocked complex. Science (New York, N.Y.), 2012;335(6071):977-981.  https://doi.org/10.1126/science.1214270
  39. Frevert J. Content of botulinum neurotoxin in Botox/Vistabel, Dysport/Azzalure, and Xeomin/Bocouture. Drugs in R&D. 2010;10(2):67-73.  https://doi.org/10.2165/11584780-000000000-00000
  40. Dressler D, Adib Saberi F, Bigalke H. Botulinum toxin therapy: reduction of injection site pain by pH normalisation. Journal of Neural Transmission (Vienna, Austria: 1996), 2016;123(Botulinum toxin therapy, 5):527-531.  https://doi.org/10.1007/s00702-016-1522-9
  41. Rupp D, Nino C, Steward LE; Brin MF Brideau-Andersen A. Botulax Displays Lower Enzymatic Activity When Compared With OnabotulinumtoxinA in a Light Chain Activity Assay. TOXINS 2021 Virtual Conference January 16-17, 2021.
  42. Brin MF, James C, Maltman J. Botulinum toxin type A products are not interchangeable: a review of the evidence. Biologics: Targets & Therapy, 2014;8(Botulinum toxin type A products are not interchangeable):227-241.  https://doi.org/10.2147/BTT.S65603
  43. Aoki KR. Preclinical update on BOTOX® (botulinum toxin type A)-purified neurotoxin complex relative to other botulinurn neurotoxin preparations. European Journal of Neurology. 1999;6(S4):3-10. 
  44. Chung ME, Song DH, Park JH. Comparative study of biological activity of four botulinum toxin type A preparations in mice. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2013;39(1 Pt 2):155-164.  https://doi.org/10.1111/dsu.12071
  45. Carruthers A, Carruthers J, Said S. Dose-ranging study of botulinum toxin type A in the treatment of glabellar rhytids in females. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2005;31(4):414-422; discussion 422.  https://doi.org/10.1111/j.1524-4725.2005.31107
  46. Beer KR, Boyd C, Patel RK, Bowen B, James SP, Brin MF. Rapid onset of response and patient-reported outcomes after onabotulinumtoxinA treatment of moderate-to-severe glabellar lines. Journal of drugs in dermatology: JDD. 2011;10(1):39-44. 
  47. Rappl T, Parvizi D, Friedl H, Wiedner M, May S, Kranzelbinder B, Wurzer P, Hellbom B. Onset and duration of effect of incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA in the treatment of glabellar frown lines: a randomized, double-blind study. Clinical, Cosmetic and Investigational Dermatology, 2013;6(Onset and duration of effect of incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA in the treatment of glabellar frown lines):211-219.  https://doi.org/10.2147/CCID.S41537
  48. De Boulle K, Werschler WP, Gold MH, Bruce S, Sattler G, Ogilvie P, Street J, Larsen KE, Yushmanova I, Lei X, Lee E, Vitarella D, Mao C. Phase 3 Study of OnabotulinumtoxinA Distributed Between Frontalis, Glabellar Complex, and Lateral Canthal Areas for Treatment of Upper Facial Lines. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2018;44(11):1437-1448. https://doi.org/10.1097/DSS.0000000000001612
  49. Fagien S, Cohen JL, Coleman W, Monheit G, Carruthers J, Street J, Larsen KE, Yushmanova I, Lei X, Lee E, Vitarella D, Mao C. Forehead Line Treatment With OnabotulinumtoxinA in Subjects With Forehead and Glabellar Facial Rhytids: A Phase 3 Study. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2017;43(3, Forehead Line Treatment With OnabotulinumtoxinA in Subjects With Forehead and Glabellar Facial Rhytids):274-284.  https://doi.org/10.1097/DSS.0000000000001414
  50. Lowe P, Patnaik R, Lowe N. Comparison of two formulations of botulinum toxin type A for the treatment of glabellar lines: a double-blind, randomized study. Journal of the American Academy of Dermatology. 2006;55(Comparison of two formulations of botulinum toxin type A for the treatment of glabellar lines, 6):975-980.  https://doi.org/10.1016/j.jaad.2006.07.006
  51. Glogau R, Kane M, Beddingfield F, Somogyi C, Lei X, Caulkins C, Gallagher C. OnabotulinumtoxinA: a meta-analysis of duration of effect in the treatment of glabellar lines. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2012;38(OnabotulinumtoxinA, 11):1794-1803. https://doi.org/10.1111/j.1524-4725.2012.02582.x
  52. Trindade de Almeida AR, Marques E, Almeida J de, Cunha T, Boraso R. Pilot study comparing the diffusion of two formulations of botulinum toxin type A in patients with forehead hyperhidrosis. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2007; 33(1 Spec No.):37-43.  https://doi.org/10.1111/j.1524-4725.2006.32330.x
  53. Cliff SH, Judodihardjo H, Eltringham E. Different formulations of botulinum toxin type A have different migration characteristics: a double-blind, randomized study. Journal of Cosmetic Dermatology. 2008;7(Different formulations of botulinum toxin type A have different migration characteristics, 1):50-54.  https://doi.org/10.1111/j.1473-2165.2008.00361.x
  54. Hexsel D, Brum C, Prado DZ do, Soirefmann M, Rotta FT, Dal’Forno T, Rodrigues TC. Field effect of two commercial preparations of botulinum toxin type A: a prospective, double-blind, randomized clinical trial. Journal of the American Academy of Dermatology. 2012;67(Field effect of two commercial preparations of botulinum toxin type A, 2):226-232.  https://doi.org/10.1016/j.jaad.2011.08.011
  55. Kerscher M, Roll S, Becker A, Wigger-Alberti W. Comparison of the spread of three botulinum toxin type A preparations. Archives of Dermatological Research. 2012;304(2):155-161.  https://doi.org/10.1007/s00403-011-1179-z
  56. Minor V. Ein neues Verfahren zu der klinischen Untersuchung der Schweißabsonderung. Deutsche Zeitschrift für Nervenheilkunde. 1928;101(1):302-308.  https://doi.org/10.1007/BF01652699
  57. Jiang H-Y, Chen S, Zhou J, Leung KK, Yu P. Diffusion of two botulinum toxins type A on the forehead: double-blinded, randomized, controlled study. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2014;40(Diffusion of two botulinum toxins type A on the forehead, 2):184-192.  https://doi.org/10.1111/dsu.12405
  58. Naumann M, Carruthers A, Carruthers J, Aurora SK, Zafonte R, Abu-Shakra S, Boodhoo T, Miller-Messana MA, Demos G, James L, Beddingfield F, VanDenburgh A, Chapman MA, Brin MF. Meta-analysis of neutralizing antibody conversion with onabotulinumtoxinA (BOTOX) across multiple indications. Movement Disorders: Official Journal of the Movement Disorder Society. 2010;25(13):2211-2218. https://doi.org/10.1002/mds.23254
  59. Jankovic J, Carruthers J, Naumannd M, Boodhooe T, Guptae S, Attare M, Singhe R, Yushmanova I, Solimane J, Brine MF, Shene J. Neutralizing Antibody Conversion With Onabotulinumtoxin A From Global Studies Across Multiple Indications in Nearly 30,000 Patient Records: A Meta-analysis. TOXINS 2021 Virtual Conference January 16-17, 2021.
  60. Mathevon L, Declemy A, Laffont I, Perennou D. Immunogenicity induced by botulinum toxin injections for limb spasticity: A systematic review. Annals of Physical and Rehabilitation Medicine. 2019;62(Immunogenicity induced by botulinum toxin injections for limb spasticity, 4):241-251.  https://doi.org/10.1016/j.rehab.2019.03.004
  61. Stotland MA, Kowalski JW, Ray BB. Patient-reported benefit and satisfaction with botulinum toxin type A treatment of moderate to severe glabellar rhytides: results from a prospective open-label study. Plastic and Reconstructive Surgery. 2007;120(Patient-reported benefit and satisfaction with botulinum toxin type A treatment of moderate to severe glabellar rhytides, 5):1386-1393. https://doi.org/10.1097/01.prs.0000279377.86280.8d
  62. Boulle K. de Patient satisfaction with different botulinum toxin type A formulations in the treatment of moderate to severe upper facial rhytids. Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology. 2008;10(2):87-92.  https://doi.org/10.1080/14764170701854679
  63. Rivkin AZ, Ogilvie P, Dayan S, Yoelin SG, Weichman BM, Garcia JK. OnabotulinumtoxinA for Simultaneous Treatment of Upper Facial Lines: Subject-Reported Satisfaction and Impact From a Phase 3 Study. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2020;46(OnabotulinumtoxinA for Simultaneous Treatment of Upper Facial Lines, 1):50-60.  https://doi.org/10.1097/DSS.0000000000001883
  64. Ogilvie P, Rivkin AZ, Dayan S, Yoelin SG, Weichman BM, Garcia JK. OnabotulinumtoxinA for Treatment of Forehead and Glabellar Lines: Subject-Reported Satisfaction and Impact From a Phase 3 Double-Blind Study. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2019;45(OnabotulinumtoxinA for Treatment of Forehead and Glabellar Lines, 5):689-699.  https://doi.org/10.1097/DSS.0000000000001779
  65. Palm MD, Few J, Patel T, Safa M, Drinkwater A, Mao C, Garcia JK. Efficacy, Patient-Reported Outcomes, and Safety for Millennial Subjects Treated With OnabotulinumtoxinA for Moderate to Severe Horizontal Forehead Lines. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2020;46(5):653-661.  https://doi.org/10.1097/DSS.0000000000002216
  66. Trindade de Almeida A, Carruthers J, Cox SE, Goldman MP, Wheeler S, Gallagher CJ. Patient satisfaction and safety with aesthetic onabotulinumtoxinA after at least 5 years: a retrospective cross-sectional analysis of 4,402 glabellar treatments. Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et al.]. 2015;41(1, Patient satisfaction and safety with aesthetic onabotulinumtoxinA after at least 5 years):19-28.  https://doi.org/10.1097/DSS.0000000000000275
  67. Banegas RA, Farache F, Rancati A, Chain M, Gallagher CJ, Chapman MA, Caulkins CA. The South American Glabellar Experience Study (SAGE): a multicenter retrospective analysis of real-world treatment patterns following the introduction of incobotulinumtoxinA in Argentina. Aesthetic Surgery Journal. 2013;33(The South American Glabellar Experience Study (SAGE), 7):1039-1045. https://doi.org/10.1177/1090820X13503475
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