ReviewToxins2021
Botulinum Toxin Type A for Glabellar Frown Lines: What Impact of Higher Doses on Outcomes?
Review in Toxins, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed.
- Efficacy and Safety of RelabotulinumtoxinA, a New Ready-to-Use Liquid Formulation Botulinum Toxin: Results From the READY-1 Double-Blind, Randomized, Placebo-Controlled Phase 3 Trial in Glabellar Lines.Aesthetic surgery journal · 2024Trial
- Safety and Duration of Effect of 40-Unit PrabotulinumtoxinA-xvfs for the Treatment of Moderate to Severe Glabellar Lines in Adult Patients: A Phase II, Multicenter, Randomized, Double-Blind, Active-Controlled Trial.Aesthetic surgery journal · 2024Trial
- Subject satisfaction and psychological well-being with escalating abobotulinumtoxinA injection dose for the treatment of moderate to severe glabellar lines.Journal of cosmetic dermatology · 2022Trial
- Muscles as Basic Therapeutic Units in Glabellar Botulinum Toxin Injection: Technique Description and Preliminary Clinical Experience.Aesthetic plastic surgery · 2026Article
- From Morphology to Multi-Omics: A New Age of Fusarium Research.Pathogens (Basel, Switzerland) · 2025Review
- Why Dosing Matters: A Closer Look at the Dose-Response Relationship With OnabotulinumtoxinA.Journal of cosmetic dermatology · 2025Review
- Facial neuromodulator expectations of treatment naïve millennials.Archives of dermatological research · 2025Article
- Article
- Article
- Anatomy, Etiology, Management, and Medico-Legal Implications of Botulinum-induced Blepharoptosis.Current reviews in clinical and experimental pharmacology · 2025Review
- Effect of Sub-Eyebrow Small Incision Dissection of the Corrugator Supercilii Muscle Combined with Autologous Block Fat Transplantation for the Treatment of Severe Frown Lines.Clinical, cosmetic and investigational dermatology · 2025Article
- Consensus Statement on the Use of Botulinum Neurotoxin in the Middle East.Clinical, cosmetic and investigational dermatology · 2023Article
- DAXI (DaxibotulinumtoxinA) - An Innovative Approach for Frown Lines.International journal of general medicine · 2023Article
- Safety of High-Dose Botulinum Toxin Injections for Parotid and Submandibular Gland Radioprotection.Toxins · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Botulinum toxin serotype-A (BoNT-A) preparations are widely used to improve the appearance of wrinkles. While effective and well tolerated, patients require retreatment over time to re-establish the effects. There is growing interest from patients as to whether higher doses can prolong response without significantly increasing side effects. We reviewed the efficacy and safety evidence for high-dose BoNT-A treatment of glabellar lines, by evaluating high-dose studies published since 2015. Toxins approved for glabellar line treatment in the US or Europe were considered. "High-dose" indicated doses above the licensed dose for each BoNT-A preparation. Five studies met the inclusion criteria and most were randomized, double-blind trials; designs and population sizes varied. Findings suggested that higher-dose BoNT-A treatment is feasible and may improve response duration without increased safety issues. Around 9 months' median duration was achieved with a 2-2.5-fold increase of the abobotulinumtoxinA on-label dose, or with a 5-fold increase in incobotulinumtoxinA dose. A 2-4-fold increase of the onabotulinumtoxinA on-label dose yielded a median duration of around 6 months. Importantly, patient satisfaction and natural look remained with increasing abobotulinumtoxinA doses. While more data are needed, these findings may lead to more effective, individually tailored treatment plans to meet patient expectations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.