Differential characteristics of incobotulinumtoxinA and its use in the management of glabellar frown lines

Figures & data

Figure 1 Muscles involved in glabellar frown lines. Reproduced with permission from Merz Pharmaceuticals GmbH.

Table 1 Use of botulinum neurotoxin type A products for the treatment of glabellar frown lines: manufacturer’s recommendations^24,27,37

Manufacturer’s recommendations	IncobotulinumtoxinA	OnabotulinumtoxinA	AbobotulinumtoxinA
Dose for glabellar frown lines	20 U	20 U	50 U
Number of injection sites	5	5	5
Volume administered per injection site	0.1 mL (4 U)	0.1 mL (4 U)	0.05 mL (10 U)
Needle size	30 G needle	30 G needle	29–30 G needle
Minimum treatment interval	3 months	3 months	3 months

Figure 2 Injection sites for treatment of glabellar frown lines. Reproduced with permission from Merz Pharmaceuticals GmbH.

Table 2 Summary of characteristics of botulinum neurotoxin type A products used in the treatment of glabellar frown lines^{24,27,37,57,60,61,91}

	IncobotulinumtoxinA (Xeomin^®/Bocouture^®)	OnabotulinumtoxinA (Botox^®/Vistabel^®)	AbobotulinumtoxinA (Dysport^®/Azzalure^®)
Manufacturer	Merz Pharmaceuticals GmbH	Allergan Inc	Ibsen Inc/Medicis Inc
Molecular mass (kDa)	150	900	500–700
Complexing proteins	No	Yes	Yes
Mean maximal area of anhidrosis in the forehead area	364.3 ± 138.1 mm^2 (per 5 U)	343.1 ± 110.7 mm^2 (per 5 U)	459.1 ± 151.8 mm^2 (per 12.5 U)
Units/vial	100/50	100/50	500/300
Mean amount of neurotoxin per 100 units	0.44 ng (Cv = 1.9%)	0.73 ng (Cv = 3.5%)	0.65 ng (Cv = 11.4%)
Specific neurotoxin potency	227 U/ng	137 U/ng	154 U/ng
IncobotulinumtoxinA:unit conversion ratio	1:1	1:1	1:2.5–3
Dosage	20 U	20 U	50 U
Shelf-life	3 years	3 years	2 years
Storage	Up to 25°C (no refrigeration required)	2°C–8°C (refrigeration required)	2°C–8°C (refrigeration required)

Abbreviation: CV, coefficient variant.

Figure 3 Amount of clostridial protein and neurotoxin per 100 U of incobotulinumtoxinA, onabotulinumtoxinA, and abobotulinumtoxinA.^37,61,72

Figure 4 Subject assessment of response with 20 U, using a 4-point scale where a responder was defined as a subject with at least a 1-point improvement compared with baseline at Day 30 from two Phase iii, placebo-controlled trials: (A) Carruthers et al,⁴² full-analysis set; and (B) Hanke et al,⁴³ full-analysis set, observed cases.

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