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!
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.
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.
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.
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!)
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.
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).
It recently launched commercial operations in Great Britain.
Nuceiva (botulinum toxin type A) is approved for vertical lines between the eyebrows seen at maximum frown.
The safety and efficacy of Nuceiva has been evaluated through the largest head-to-head pivotal study versus BOTOX to date.
In a study, 540 adult patients were enrolled. Patients received a single treatment 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 91.5% (Nuceiva patients) were satisfied. No serious adverse events were assessed.
I am awaiting a launch date for this in the UK so will not be trying it just yet.
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.
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