ReviewJournal of cosmetic dermatology2025
Why Dosing Matters: A Closer Look at the Dose-Response Relationship With OnabotulinumtoxinA.
Review in Journal of cosmetic dermatology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundOnabotulinumtoxinA is licensed in many countries for simultaneous treatment of three areas of the upper face: glabellar lines, 20 U; lateral canthal lines, 24 U; and forehead lines, 20 U.
aimsTo assess the onabotulinumtoxinA dosing science and dose-response relationship in the treatment of upper facial lines (UFL).
methodsKey practical questions are addressed using available data.
resultsOnabotulinumtoxinA doses were selected for Phase 3 registrational trials based on rigorous dose-ranging studies. In clinical practice, it is important to consider the relationship between dose and efficacy outcomes, duration, and safety. Interstudy comparison of duration analyses is complicated by the lack of a single comprehensive definition, but trial data with standard onabotulinumtoxinA dosing in the glabella suggest a median effect duration of ~4 months. Treatment of UFL at below the approved dose is associated with a shorter duration, inferior response rates, and lower patient satisfaction; there is no evidence that underdosing reduces adverse event risk. It may therefore be advisable to avoid going below the licensed dose unless there is a clear clinical rationale. By contrast, there is growing evidence that treatment outcomes can be further improved using doses above those currently licensed, without adversely affecting safety-as demonstrated in the glabella. Further studies are needed to assess this in lateral canthal and forehead lines. Additional work is also required to examine potential ceiling doses and better understand the dose-response relationship in patient subgroups.
conclusionsAppropriate dosing of onabotulinumtoxinA is essential for maximizing benefit and ensuring patient satisfaction.
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