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Neue Botulinumtoxine in der ästhetischen Dermatologie

Ein umfassender Überblick

New botulinum toxins for aesthetic dermatology

A comprehensive review

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Zusammenfassung

Die Gesichtsrejuvenation genießt sehr große Popularität unter Patienten wie Ärzten. Botulinumtoxine (BoNTs) aus Bakterien stellen gut tolerierte Optionen der minimal-invasiven Intervention in der Gesichtsverjüngung und bei anderen ästhetischen Prozeduren dar. Diese Produkte haben die ästhetischen Behandlungen revolutioniert. Es existieren mehrere Subtypen des Toxins. Zurzeit werden die Subtypen A und B für medizinische Zwecke genutzt. Allerdings ist nur der Subtyp A für kosmetische Anwendungen in Deutschland und den USA zugelassen. Jedes der BoNT-A-Produkte hat eine einzigartige Zusammensetzung. Das Verständnis der verschiedenen BoNT-A-Produkte ist unabdingbar für die individuelle Auswahl zur Behandlung der Patienten. In dieser Übersicht besprechen wir die BoNT-Produkte für die ästhetische Anwendung.

Abstract

Facial rejuvenation is gaining immense popularity among patients and clinicians. Botulinum toxins derived from bacteria are well-tolerated options as minimally invasive interventions for facial rejuvenation or other aesthetic procedures. These products have revolutionized aesthetic treatments. Several types of botulinum toxins (BoNT) are available. Currently type A and B are clinically used and only BoNT‑A products are approved for use for cosmetic indications in the Germany and the United States. Each product is unique in terms of its composition. Understanding the various BoNT‑A products is essential in choosing the optimal treatment for our patients. In this article we discuss different BoNT‑A products used for aesthetic intervention.

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Literatur

  1. De Boulle K, Fagien S, Sommer B, Glogau R (2010) Treating glabellar lines with botulinum toxin type A‑hemagglutinin complex: a review of the science, the clinical data, and patient satisfaction. Clin Interv Aging 5:101–118

    PubMed  PubMed Central  Google Scholar 

  2. Wiest LG (2009) An overview of the cosmetic treatment of facial muscles with a new botulinum toxin. Acta Dermatovenerol Croat 17:48–53

    PubMed  Google Scholar 

  3. Ting PT, Freiman A (2004) The story of Clostridium botulinum: from food poisoning to Botox. Clin Med 4:258–261

    Article  Google Scholar 

  4. Carruthers A, Kane MAC, Flynn TC et al (2013) The convergence of medicine and neurotoxins: a focus on botulinum toxin type a and its application in aesthetic medicine – a global, evidence-based botulinum toxin consensus education initiative part I: Botulinum toxin in clinical and cosmetic practice. Dermatol Surg 39:493–509

    Article  CAS  PubMed  Google Scholar 

  5. Feily A, Fallahi H, Zandian D, Kalantar H (2011) A succinct review of botulinum toxin in dermatology; update of cosmetic and noncosmetic use. J Cosmetic Dermatol 10:58–67

    Article  Google Scholar 

  6. Hexsel D, Spencer JM, Woolery-Lloyd H, Gilbert E ( (2010) Practical applications of a new botulinum toxin. J Drugs Dermatol 9(3 Suppl):S31–S37

    Google Scholar 

  7. Lowe NJ, Shah A, Lowe PL, Patnaik R (2010) Dosing, efficacy and safety plus the use of computerized photography for botulinum toxins type A for upper facial lines. J Cosmet Laser Ther 12:106–111

    Article  PubMed  Google Scholar 

  8. Wright G, Lax A, Mehta SB (2018) A review of the longevity of effect of botulinum toxin in wrinkle treatments. Br Dent J 224:255–260

    Article  CAS  PubMed  Google Scholar 

  9. Benecke R (2012) Clinical relevance of botulinum toxin immunogenicity. BioDrugs 26:e1–e9

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Wollina U (2008) Botulinum toxin: non-cosmetic indications and possible mechanisms of action. J Cutan Aesthet Surg 1:3–6

    Article  PubMed  PubMed Central  Google Scholar 

  11. Freeman SR, Cohen JL (2008) New neurotoxins on the horizon. Aesthet Surg J 28:325–330

    Article  PubMed  Google Scholar 

  12. Kumar R, Dhaliwal HP, Kukreja RV, Singh BR (2016) The botulinum toxin as a therapeutic agent: molecular structure and mechanism of action in motor and sensory systems. Semin Neurol 36:10–19

    Article  PubMed  Google Scholar 

  13. Kaltreider SA, Kennedy RH, Woog JJ et al (2005) Cosmetic oculofacial applications of botulinum toxin a report by the American Academy of Ophthalmology. Ophthalmology 112:1159–1167

    Article  PubMed  Google Scholar 

  14. Lowe N, Lowe P (2012) Botulinum toxins for facial lines: a concise review. Dermatol Ther 2:14

    Article  Google Scholar 

  15. Sattler G (2010) Current and future botulinum neurotoxin type a preparations in aesthetics: a literature review. J Drugs Dermatol 9:1065–1071

    PubMed  Google Scholar 

  16. Kane MA, Monheit G (2017) The practical use of abobotulinumtoxin A in aesthetics. Aesthet Surg J 37(Suppl 1):S12–S19

    Article  PubMed  PubMed Central  Google Scholar 

  17. Walker JJ, Dayan SH (2014) Comparison and overview of currently available neurotoxins. J Clin Aesthet Dermatol 7:31–39

    PubMed  PubMed Central  Google Scholar 

  18. Park J‑Y, Sunga O, Wanitphakdeedecha R, Frevert J (2020) Neurotoxin impurities: a review of threats to efficacy. Plast Reconstr Surg Glob Open 8:e2627

    Article  PubMed  PubMed Central  Google Scholar 

  19. Carruthers JA, Lowe NJ, Menter MA et al (2002) A multicenter, double-blind, randomized, placebo-controlled study of the efficacy and safety of botulinum toxin type A in the treatment of glabellar lines. J Am Acad Dermatol 46:840–849

    Article  PubMed  Google Scholar 

  20. Carruthers A, Carruthers J, Lowe NJ et al (2004) One-year, randomized, multicenter, two-period study of the safety and efficacy of repeated treatments with botulinum toxin type A in patients with glabellar lines. J Clin Res 7:1–20

    Google Scholar 

  21. Carruthers A, Carruthers J, Fagien S et al (2016) Repeated onabotulinumtoxin a treatment of glabellar lines at rest over three treatment cycles. Dermatol Surg 42:1094–1101

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Frampton JE, Easthope SE (2003) Botulinum toxin A (Botox Cosmetic): a review of its use in the treatment of glabellar frown lines. Am J Clin Dermatol 4:709–725

    Article  PubMed  Google Scholar 

  23. Botox PI. https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/103000s5236lbl.pdf. Zugegriffen: 27. Dez. 2020

  24. Carruthers A, Carruthers J (2008) Botulinum toxin products overview. Skin Therapy Lett 13:1–4

    CAS  PubMed  Google Scholar 

  25. Nestor M, Ablon G, Pickett A (2017) Key parameters for the use of abobotulinumtoxin A in aesthetics: onset and duration. Aesthet Surg J 37:S20–S31

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kane MAC, Brandt F, Rohrich RJ et al (2009) Evaluation of variable-dose treatment with a new U.S. Botulinum Toxin Type A (Dysport) for correction of moderate to severe glabellar lines: results from a phase III, randomized, double-blind, placebo-controlled study. Plast Reconstr Surg 124:1619–1629

    Article  CAS  PubMed  Google Scholar 

  27. Brandt F, Swanson N, Baumann L, Huber B (2009) Randomized, placebo-controlled study of a new botulinum toxin type a for treatment of glabellar lines: efficacy and safety. Dermatol Surg 35:1893–1901

    Article  CAS  PubMed  Google Scholar 

  28. Baumann L, Brandt FS, Kane MAC, Donofrio LM (2009) An analysis of efficacy data from four phase III studies of botulinum neurotoxin type A‑ABO for the treatment of glabellar lines. Aesthet Surg J 29(Suppl 6):S57–S65

    Article  PubMed  Google Scholar 

  29. Cohen JL, Schlessinger J, Cox SE, Lin X, Reloxin Investigational Group (2009) An analysis of the long-term safety data of repeat administrations of botulinum neurotoxin type A‑ABO for the treatment of glabellar lines. Aesthet Surg J 29(Suppl 6):S43–S49

    Article  PubMed  Google Scholar 

  30. Rubin M, Dover J, Mass C, Nestor M (2009) An analysis of safety data from five phase III clinical trials on the use of botulinum neurotoxin type A‑ABO for the treatment of glabellar lines. Aesthet Surg J 29(Suppl 6):S50–S56

    Article  PubMed  Google Scholar 

  31. Lawrence I, Moy R (2009) An evaluation of neutralizing antibody induction during treatment of glabellar lines with a new US formulation of botulinum neurotoxin type A. Aesthet Surg J 29(Suppl 6):S66–S71

    Article  PubMed  Google Scholar 

  32. Gubanova E, Tabet MH, Bergerova Y et al (2018) Assessment of subject and physician satisfaction after long-term treatment of glabellar lines with abobotulinumtoxinA (Dysport ®/Azzalure ®): Primary results of the APPEAL noninterventional study. Aesthetic Plast Surg 42:1672–1680

    Article  PubMed  PubMed Central  Google Scholar 

  33. Dysport. PI. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/125274s107lbl.pdf. Zugegriffen: 27. Dez. 2020

  34. Cohen JL, Scuderi N (2017) Safety and patient satisfaction of abobotulinumtoxina for aesthetic use: a systematic review. Aesthet Surg J 37:S32–S44

    Article  PubMed  PubMed Central  Google Scholar 

  35. Redaelli A, Saromytskaya A, Roland Payne C et al (2017) International experts recommendations on the use of AboBotulinum Toxin A (AboTA) for facial rejuvenation and primary hyperhidrosis. Cosmet Med Int 3:70–80

    Google Scholar 

  36. Kim JE, Song EJ, Choi GS et al (2015) The efficacy and safety of liquid-type botulinum toxin type A for the management of moderate to severe glabellar frown lines. Plast Reconstr Surg 135:732–741

    Article  CAS  PubMed  Google Scholar 

  37. Ascher B, Rzany B, Kestemont P et al (2020) Liquid formulation of abobotulinumtoxin A: A 6‑month, phase 3, double-blind, randomized, placebo-controlled study of a single treatment, ready-to-use toxin for moderate-to-severe glabellar lines. Aesthet Surg J 40:93–104

    Article  PubMed  Google Scholar 

  38. Ascher B, Rzany B, Kestemont P et al (2020) significantly increased patient satisfaction following liquid formulation abobotulinumtoxin A treatment in glabellar lines: face‑q outcomes from a phase 3 clinical trial. Aesthet Surg J 40:1000–1008

    Article  PubMed  Google Scholar 

  39. Frevert J (2009) Xeomin: an innovative new botulinum toxin type A. Eur J Neurol 16(Suppl 2):11–13

    Article  PubMed  Google Scholar 

  40. Oh H‑M, Park JH, Song DH, Chung ME (2015) Efficacy and safety of a new botulinum toxin type a free of complexing proteins. Toxins 8:4

    Article  PubMed Central  CAS  Google Scholar 

  41. Xeomin. https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/125360s073lbl.pdf. Zugegriffen: 27. Dez. 2020

  42. Kerscher M, Rzany B, Prager W et al (2015) efficacy and safety of incobotulinumtoxin A in the treatment of upper facial lines: results from a randomized, double-blind, placebo-controlled, phase III study. Dermatol Surg 41:1149–1157

    Article  CAS  PubMed  Google Scholar 

  43. Prager W, Nogueira Teixeira D, Leventhal PS (2017) Incobotulinumtoxin A for aesthetic indications: a systematic review of prospective comparative trials. Dermatol Surg 43:959–966

    Article  CAS  PubMed  Google Scholar 

  44. Jones DH, Kerscher M, Geister T, Hast MA, Weissenberger P (2017) Efficacy of incobotulinumtoxin A for the treatment of glabellar frown lines in male subjects: post-hoc analyses from randomized, double-blind pivotal studies. Dermatol Surg 43:S235–S241

    Article  CAS  PubMed  Google Scholar 

  45. Chao YY, Tseng FW, Yang YL et al (2019) Incobotulinumtoxin A for the treatment of glabellar frown lines: a prospective, multicenter, single-arm study in Taiwan. J Clin Aesthet Dermatol 12:E53–E57

    PubMed  PubMed Central  Google Scholar 

  46. Fischer T, Sattler G, Prager W et al (2020) Safety, tolerability, and efficacy of repeat-dose injections of incobotulinumtoxin A in the treatment of upper facial lines: results from a prospective, open-label, phase III study. J Drugs Dermatol 19:461–469

    Article  PubMed  Google Scholar 

  47. Kerscher M, Fabi S, Fischer T et al (2020) Incobotulinumtoxin A demonstrates safety and prolonged duration of effect in a dose-ranging study for glabellar lines. J Drugs Dermatol 19:985–991

    Article  PubMed  Google Scholar 

  48. de Sanctis Pecora C, Pinheiro MVB, Ventura Ferreira K, Jacobino de Barros Nunes G, Miot HA (2021) The One21 technique: an individualized treatment for glabellar lines based on clinical and anatomical landmarks. Clin Cosmet Investig Dermatol 14:97–105

    Article  PubMed  PubMed Central  Google Scholar 

  49. Vachiramon V, Subpayasarn U, Triyangkulsri K, Jurairattanaporn N, Rattananukrom T (2021) Different injection patterns of incobotulinumtoxinA for crow’s feet: a split-face comparative study. J Eur Acad Dermatol Venereol 35:256–262

    Article  CAS  PubMed  Google Scholar 

  50. Park JY, Cho SI, Hur K, Lee DH (2021) Intradermal microdroplet injection of diluted incobotulinumtoxin‑A for sebum control, face lifting, and pore size improvement. J Drugs Dermatol 20:49–54

    Article  PubMed  Google Scholar 

  51. Ferreira LM, Filho ST, Costa RO et al (2009) Efficacy and tolerability of a new botulinum toxin type a for cosmetic treatment of dynamic facial wrinkles: a prospective, phase III multicenter study. Surg Cosmet Dermatol 1:58–63

    Google Scholar 

  52. da Costa A, Pereira ESP, de Oliveira Pereira M et al (2019) Six-month comparative analysis monitoring the progression of the largest diameter of the sweating Inhibition halo of different botulinum toxins type‑A. Aesthet Surg J 39:993–1004

    Article  PubMed  Google Scholar 

  53. FDA 761085Orig1s000 – FDA. https://www.accessdata.fda.gov › drugsatfda_docs › nda. Zugegriffen: 15. Jan. 2021

  54. Cheon HI, Jung N, Won CH et al (2019) Efficacy and safety of prabotulinumtoxin A and onabotulinumtoxin A for crow’s feet: a phase 3, multicenter, randomized, double-blind, split-face study. Dermatol Surg 45:1610–1619

    Article  CAS  PubMed  Google Scholar 

  55. Carruthers J, Solish N, Humphrey S et al (2017) injectable daxibotulinumtoxin A for the treatment of glabellar lines: a phase 2, randomized, dose-ranging, double-blind, multicenter comparison with onabotulinumtoxina and placebo. Dermatol Surg 43:1321–1331

    Article  CAS  PubMed  Google Scholar 

  56. Carruthers JD, Fagien S, Joseph JH et al (2020) Daxibotulinumtoxin A for injection for the treatment of glabellar lines: results from each of two multicenter, randomized, double-blind, placebo-controlled, phase 3 studies (SAKURA 1 and SAKURA 2). Plast Reconstr Surg 145:45–58

    Article  CAS  PubMed  Google Scholar 

  57. Fabi SG, Cohen JL, Green LJ et al (2021) Daxibotulinumtoxin A for injection for the treatment of glabellar lines: efficacy results from sakura 3, a large, open-label, phase 3 safety study. Dermatol Surg 47:48–54

    Article  PubMed  Google Scholar 

  58. Green JB, Mariwalla K, Coleman K et al (2021) A large, open-label, phase 3 safety study of daxibotulinumtoxin A for injection in glabellar lines: a focus on safety from the SAKURA 3 study. Dermatol Surg 47:42–46

    Article  PubMed  Google Scholar 

  59. Clinical Trial.gov: NCT00752050; NCT00752258; NCT00752297.

  60. Microgen. https://www.microgen.ru. Zugegriffen: 16. Jan. 2021

  61. Yoon JS, Kim JC, Lee SY (2009) Double-blind, randomized, comparative study of Meditoxin versus Botox in the treatment of essential blepharospasm. Korean J Ophthalmol 23:137–141

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  62. Clinical Trial.gov: NCT03289169

  63. Jeong-yeo L (2020) Drug Ministry revokes Meditoxin license. The Korean Herald vom 18. Juni 2020

  64. Frevert J, Ahn KY, Park MY, Sunga O (2018) Comparison of botulinum neurotoxin type A formulations in Asia. Clin Cosmet Investig Dermatol 11:327–331

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Ahsanuddin S, Roy S, Nasser W et al (2020) Adverse events associated with Botox as reported in a Food and Drug Administration Database. Aesthetic Plast Surg. https://doi.org/10.1007/s00266-020-02027-z

    Article  PubMed  Google Scholar 

  66. Wollina U, Konrad H (2005) Managing adverse events associated with botulinum toxin type A: a focus on cosmetic procedures. Am J Clin Dermatol 6:141–150

    Article  PubMed  Google Scholar 

  67. Philipp-Dormston WG, Bergfeld D, Sommer B, die Onabotulinumtoxin-Konsensusgruppe (2013) Konsensusempfehlungen zur Behandlung mit Onabotulinumtoxin A in der ästhetischen Medizin. J Dtsch Dermatol Ges 11(S1):1–42

    Google Scholar 

  68. Anido J, Arenas D, Arruabarrena C et al (2017) Tailored botulinum toxin type A injections in aesthetic medicine: consensus panel recommendations for treating the forehead based on individual facial anatomy and muscle tone. Clin Cosmet Investig Dermatol 10:413–421

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to M. Goldust.

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A. Patil, M. Kassir, U. Wollina und M. Goldust geben an, dass kein Interessenkonflikt besteht.

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Patil, A., Kassir, M., Wollina, U. et al. Neue Botulinumtoxine in der ästhetischen Dermatologie. Hautarzt 72, 393–402 (2021). https://doi.org/10.1007/s00105-021-04801-9

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