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评价一种新型美国肉毒毒素 A(Dysport)的剂量可变治疗方案用于矫正中重度眉间纹的效果:一项 III 期、随机、双盲、安慰剂对照研究的结果。

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.

机构信息

New York and White Plains, N.Y.; Coral Gables, Fla.; Dallas, Texas; and Birmingham, Ala. From the Manhattan Eye, Ear and Throat Hospital, the Dermatology Research Institute LLC, the University of Texas Southwestern Medical Center, New York Dermatology Surgery and Laser, and the Total Skin and Beauty Dermatology Center.

出版信息

Plast Reconstr Surg. 2009 Nov;124(5):1619-1629. doi: 10.1097/PRS.0b013e3181b5641b.

Abstract

BACKGROUND

In April, the U.S. Food and Drug Administration approved a new U.S. formulation of botulinum neurotoxin type A (Dysport; Medicis Aesthetics, Inc., Scottsdale, Ariz.). This formulation has demonstrated inhibition of glabellar lines at a 50-unit dose. Standard clinical practice is to adjust the dose based on muscle mass.

METHODS

Patients stratified by race/ethnicity were randomized to receive a single treatment of Dysport administered in various doses or placebo. Dysport was administered in a total volume of 0.4 to 0.6 ml for women (50, 60, or 70 units) and 0.5 to 0.7 ml for men (60, 70, or 80 units), based on procerus/corrugator muscle mass. Efficacy was assessed by a blinded evaluator and patient self-evaluation on days 14, 30, 60, 90, 120, and 150 after treatment.

RESULTS

At day 30, 85 percent and 87 percent of Dysport-treated patients were responders as assessed by blinded evaluator and patient self-evaluation, respectively, compared with 3 percent and 5 percent of placebo-treated patients, respectively (p < 0.001). Median duration of effect was 109 days for Dysport versus 0 days for placebo (blinded evaluator) and 107 days for Dysport versus 0 days for placebo (patient self-evaluation). Response and duration of action were slightly higher in African American patients. The majority of treatment-emergent adverse events were mild or moderate in severity.

CONCLUSION

A single treatment with Dysport, with the dose based on gender and muscle mass, is well tolerated and provides a greater and longer-lasting improvement in glabellar lines compared with placebo.

摘要

背景

今年 4 月,美国食品和药物管理局批准了一种新的美国肉毒毒素 A 制剂(Dysport;Medicis Aesthetics,Inc.,斯科茨代尔,亚利桑那州)。这种制剂已被证明在 50 个单位的剂量下可以抑制眉间纹。标准的临床实践是根据肌肉量调整剂量。

方法

按种族/民族分层的患者被随机分配接受单次 Dysport 治疗,剂量不同或接受安慰剂。Dysport 根据皱眉肌/降眉间肌的肌肉量,以 0.4 至 0.6 毫升的总量(女性为 50、60 或 70 单位)和 0.5 至 0.7 毫升(男性为 60、70 或 80 单位)给予治疗。在治疗后第 14、30、60、90、120 和 150 天,由盲法评估者和患者进行自我评估,评估疗效。

结果

在第 30 天,分别有 85%和 87%的 Dysport 治疗患者被盲法评估者和患者自我评估为应答者,而安慰剂治疗患者的应答率分别为 3%和 5%(p<0.001)。Dysport 的中位疗效持续时间为 109 天,安慰剂为 0 天(盲法评估者);Dysport 为 107 天,安慰剂为 0 天(患者自我评估)。在非裔美国患者中,反应和作用持续时间略高。大多数治疗出现的不良事件为轻度或中度。

结论

根据性别和肌肉量给予 Dysport 单次治疗,耐受性良好,与安慰剂相比,可更显著、更持久地改善眉间纹。

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