OnabotulinumtoxinA versus PrabotulinumtoxinA-xvfs: A Randomized, Triple-blind, Split-face Study on the Time to Onset, Rhytid Appearance, and Patient Satisfaction in Forehead and Glabellar Lines

Gabriella Vasile; Claudia Green; Hamza Bhatti; Muneeb Ilyas; Christopher Buckley; Eli Saleeby; Eduardo Weiss

OnabotulinumtoxinA versus PrabotulinumtoxinA-xvfs: A Randomized, Triple-blind, Split-face Study on the Time to Onset, Rhytid Appearance, and Patient Satisfaction in Forehead and Glabellar Lines

J Clin Aesthet Dermatol. 2023 May;16(5):47-49.

Authors

Gabriella Vasile¹, Claudia Green², Hamza Bhatti³, Muneeb Ilyas⁴, Christopher Buckley⁵, Eli Saleeby³, Eduardo Weiss⁶

Affiliations

¹ Dr. Vasile is with Goodman Dermatology in Roswell, Georgia, and Philadelphia College of Osteopathic Medicine in Philadelphia, Pennsylvania.
² Ms. Green is a medical student in Miami, Florida.
³ Drs. Bhatti and Saleeby are with Skin and Cancer Associates in Coral Springs, Florida.
⁴ Dr. Ilyas is with Larkin Community Hospital Palm Springs in Hialeah, Florida.
⁵ Dr. Buckley is with the Philadelphia College of Osteopathic Medicine in Philadelphia, Pennsylvania, and Goodman Dermatology in Roswell, Georgia.
⁶ Dr. Weiss is with Hollywood Dermatology and Dermatologic Surgery at the University of Miami in Miami, Florida.

PMID: 37288279
PMCID: PMC10243730

Abstract

Background: Both onabotulinumtoxinA and prabotulinumtoxinA-xvfs are FDA-approved formulations of botulinum toxin A for the treatment of glabella and forehead rhytids.

Objective: We sought to compare the onset to action and patient satisfaction of onabotulinumtoxinA and prabotulinumtoxinA-xvfs in treating dynamic rhytids of the forehead and glabella.

Methods: Fifteen patients, aged 28 to 74, were enrolled and completed the study. Patients were randomly assigned to receive equal amounts of onabotulinumtoxinA and prabotulinumtoxinA-xvfs injected to opposite sides of the face in the glabella and forehead at Day 0 by a blinded injector. Glabellar and frontalis muscle onset to action and rhytid appearance were blindly evaluated using photographs at Days 0, 2, 4, 6, 8, 10 post-injection. Patients rated their satisfaction of left and right sides using a standardized scale.

Results: There was no statistically significant difference in onset to action, rhytid appearance, and patient satisfaction after injection with onabotulinumtoxinA versus prabotulinumtoxinA-xvfs in the corrugator and frontalis muscles. Although not statistically significant, a trend existed towards increased patient satisfaction with onabotulinumtoxinA.

Conclusion: Both onabotulinumtoxinA and prabotulinumtoxinA-xvfs are equally efficacious formulations of botulinum toxin type A for the treatment of glabellar and forehead rhytids.

Keywords: Aging skin; antiaging; fillers; injectables.