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

Background: 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. Aims: To evaluate the efficacy, durability, and safety of RTUaboBoNT-A compared with OnaBoNT-A for moderate to severe glabellar wrinkles:. Methods: 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. Results: 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). Conclusion: 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.