NivobotulinumtoxinA in the Treatment of Lateral Canthal Lines Alone and With Concurrent Treatment of Glabellar Lines.

Botulinum neurotoxins in aesthetic medicine require reconstitution, which may cause administration errors. To evaluate liquid nivobotulinumtoxinA treatment of lateral canthal lines (LCL) and glabellar lines (GL). Participants with moderate-to-severe LCL with/without moderate-to-severe GL were enrolled in 2 double-blind randomized clinical trials. Study 002 participants received nivobotulinumtoxinA 24 U or placebo for LCL treatment. Study 006 participants received nivobotulinumtoxinA 24 U (LCL), nivobotulinumtoxinA 44 U (LCL+GL), or placebo. Each study allowed up to 2 additional doses. The composite primary end point was the proportion of participants achieving ≥2-grade improvement on the Facial Wrinkle Scale (FWS) by investigator and participant assessment at maximum smile; the coprimary end point was investigator- and participant-assessed FWS "none or mild" rating. At Day 30, significant responder rates versus placebo were observed for LCL in Study 002 (30.3% vs 2.6%, p < .001) and for LCL and LCL+GL in Study 006 (20.6% and 22.8% vs 0%, p < .001) for the composite end point. "None or mild" investigator/participant assessment of LCL (Study 002: 62.7%/56.5%; Study 006: 56.4%/43.6%) and LCL+GL (60.8%/47.3%) were significantly higher versus placebo (p < .001). Headache was the most common adverse event. Liquid nivobotulinumtoxinA was effective and well-tolerated for treating moderate-to-severe LCL with/without GL.