So in a previous post I talked about botulinum toxin brands and over all the years I have been using Botox and occasionally Azzalure and Bocouture in 2022 we have 3 new toxins that have launched Letybo, alluzience and Nuceiva.
However, 2022 seems to be the year of new botulinum toxin innovations! With 3 new botulinum boxins on the block!
What is Alluzience?
Alluzience is a new botulinum toxin type A from Galderma the distributor of Azzalure and Restylane. It has a registered trademark and was created by Ipsen. Alluzience has been available in other European countries since early 2022. It first became available in the UK in June 2022.
It is also known as relabotulinumtoxinA, which is the first ready-to-use BoNT-A liquid neuromodulator that does not require dilution before injection.
What are the benefits of Alluzience?
It has a quicker onset of action and can start working within 24 hours. It can also have a longer duration of action compared to the other toxin brands currently available.
What are the disadvantages of Alluzience?
If you develop a side effect such as brow droop or eyelid droop it could develop earlier and last longer.
Alluzience is a premixed prescription toxin treatment. It can often be more painful to inject than the other toxins (if you have ever had an injection with normal saline in botox rather than bacteriostatic, you will know the sting feeling) that are currently available. For many people, this is not an issue but for the more needle-phobic patient and patients with a low pain threshold, they may prefer one of the alternatives available.
So what should you know about Letybo?
Letybo [letibotulinumtoxinA] is a brand new (in the EU and UK at least) botulinum toxin type A being launched by Croma-Pharma in 2022. Croma-Pharma announced in Jan of this year that the decentralized procedure for its botulinum toxin to gain market authorization in Europe has been accomplished.
LetibotulinumtoxinA has been used in Asia where it has been market leader for years. It was developed by Hugel in South Korea in the form Botulax. It is also marketed under the names Regenox, Zentox, Reage, Magnion, Hugel Toxin, Juvenlife, Botulim, and Botoshot.
(Please note Botulax is not licensed in the UK (or FDA-approved yet) – if it is being used on you in this country it is either an illegal or fake product!)
What is the research behind it?
For the current launch by Croma-Pharma, researchers conducted three randomized, placebo-controlled phase III trials that enrolled a total of >1000 subjects in Europe and the US.
In each study, letibotulinumtoxinA was superior to a placebo in reducing glabellar (frown) line severity at week 4. It was also shown to be non-inferior to the leading competitor, Botox. It was deemed effective and safe.
What makes it different?
However, some of the research around leibotulinumotxinA as Botulax has shown some potential disadvantages. Merz Pharmaceuticals found that it contained greater amounts on inactive toxin when compared to Bocouture/Xeomin, potentially reducing clinical efficacy. There would also be an increased risk of inducing a immune reaction and causing patients to become non-responders. This would need to be explored further.
Performance beauty company Evolus has shipped the first customer orders for Nuceiva (botulinum toxin type A) and launched commercial operations in Great Britain.
Nuceiva (botulinum toxin type A) is approved for the temporary improvement in the appearance of moderate to severe vertical lines between the eyebrows seen at maximum frown (glabellar lines) when the severity of the facial lines has an important psychological impact in adults below 65 years of age. The safety and efficacy of Nuceiva were evaluated through the company’s Transparency program, the largest head-to-head pivotal study versus BOTOX to date.
A multicentre, randomised, double blind, placebo-controlled, single dose, phase III, non-inferiority study compared prabotulinumtoxin A and onabotulinumtoxin A for the treatment of moderate to severe glabellar lines in adult patients took place. In the 150-day study, 540 adult patients were enrolled. Patients were randomised to receive a single treatment (0.1ml injected into each of five glabellar sites) of 20U prabotulinumtoxin A, 20U onabotulinumtoxin A or placebo. Responder rates for the primary efficacy endpoint were 87.2% (prabotulinumtoxin A), 82.8% (onabotulinumtoxin A) and 4.2% (placebo). The difference between the two groups was 4.4%.
Patients’ level of satisfaction 30 days following injection showed that 91.5% (Nuceiva patients) were either satisfied or very satisfied compared to 86.5% (onabotulinumtoxin A patients) and 6.3% (placebo patients). No serious adverse events were assessed but the most frequently reported were headache and nasopharyngitis. The study therefore suggested that a single treatment of 20U prabotulinumtoxin A was shown to be safe and effective and non-inferior to 20U onabotulinumtoxin A.
I am awaiting a launch date for this in the UK so will not be trying it just yet.
We have covered all 3 of these new botulinum toxin anti wrinkle treatment 2 of whom claim that they are reported to last approximately six months in duration, rather than the average three of other products.
Am I suitable for any of these new treatments?
I have tried Letybo and I am not yet convinced by the claims, so I have just started using Alluzience and will be evaluating the response of my long-term regular patients to monitor progress and claims to make sure I deliver the best possible results.
If you are considering an anti wrinkle treatment: