# Is Ready‐To‐Use AbobotulinumtoxinA More Effective Than OnabotulinumtoxinA for Glabellar Lines? A Randomized, Controlled, Triple‐Blinded Clinical Trial

## TL;DR

This study compared two botulinum toxin A formulations for reducing frown lines and found they were similarly effective and safe, with minor differences in patient satisfaction and injection discomfort.

## Contribution

The study provides the first randomized, blinded comparison of ready-to-use abobotulinumtoxinA and onabotulinumtoxinA for glabellar lines.

## Key findings

- Both formulations showed comparable efficacy and durability in reducing glabellar lines.
- OnabotulinumtoxinA was associated with higher satisfaction at 2 months.
- Ready-to-use abobotulinumtoxinA caused more injection pain.

## Abstract

Most commercially available botulinum toxin A (BoNT‐A) formulations are lyophilized or vacuum‐dried powders requiring reconstitution. Recently a ready‐to‐use formulation (RTUaboBoNT‐A) has been introduced. Although its efficacy in reducing glabellar lines has been reported, comparative data with powder onabotulinumtoxinA (OnaBoNT‐A) remain limited.

To evaluate the efficacy, durability, and safety of RTUaboBoNT‐A compared with OnaBoNT‐A for moderate to severe glabellar wrinkles:

Forty women (25–50 years) were randomly allocated to receive either OnaBoNT‐A (n = 20) or RTUaboBoNT‐A (n = 20) at equivalent doses in the procerus and corrugator muscles. Outcomes included Electromyography activity (EMG), Merz 5‐point glabellar lines scale, FACE‐Q satisfaction scores, perceived age and pain intensity (VAS). Assessments were performed at baseline and 1, 2‐, 3‐, 4‐ and 5‐months post‐injection. Statistical analysis included two‐way repeated‐measures ANOVA with Bonferroni's post hoc, chi‐squared tests and independent Student's t‐tests.

No significant intergroup differences were observed in EMG activity of the assessed muscles across follow‐ups (p > 0.05). Glabellar lines severity was comparable between groups at rest and maximum contraction throughout the study (p > 0.05). Higher satisfaction scores were observed at 2‐months in the OnaBoNT‐A group (p = 0.01). Pain during injection was greater with RTUaboBoNT‐A (p = 0.02). No intergroup differences were found in perceived age (p > 0.05).

The RTUaboBoNT‐A demonstrated similar efficacy, durability, and safety profile to OnaBoNT‐A for the treatment of glabellar lines. With minor differences in satisfaction and injection disconfort.