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Therapeutic Efficacy and Safety of Recombinant Botulinum Toxin Type A for Moderate to Severe Glabellar Lines: A Randomized, Controlled, Double-blind, Phase III Trial in Chinese Adults

  • Yan Wu
  • , Xiao Long
  • , Nanze Yu
  • , Jin Chen
  • , Jianyun Lu
  • , Lina Tan
  • , Wei Lai
  • , Li Li
  • , Sufan Wu
  • , Liming Wu
  • , Jiaming Sun
  • , Hongsen Bi
  • , Songmei Geng
  • , Huiping Wang
  • , Shengkang Luo
  • , Zhiqi Hu
  • , Jianmin Yang
  • , Baoxi Wang
  • , Wu Yang
  • , Xiaoli Sun
  • Xiaoyun Sun
  • Peking University
  • Chinese Academy of Medical Sciences
  • First Affiliated Hospital of Chongqing Medical University
  • Central South University
  • Sun Yat-Sen University
  • Sichuan University
  • Zhejiang Provincial People's Hospital
  • Hangzhou First People's Hospital
  • Huazhong University of Science and Technology
  • The Second Affiliated Hospital of Xi'an Jiaotong University
  • Tianjin Medical University
  • Guangdong Second Provincial General Hoshtal
  • Nanfang Hospital
  • Beijing Tsinghua Chang Gung Hospital
  • Ltd.

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Conventional botulinum toxin type A (BoNT/A) products include non-therapeutic accessory proteins vary in composition and manufacturing processes, which may contribute to differences in purity and biochemical characteristics. YY001 (Retoxin®) is a novel recombinant BoNT/A manufactured via E. coli expression to reduce impurities, improve purity, and minimize immunogenic risk. Objectives: To evaluate the efficacy, safety, and immunogenicity of YY001, a recombinant botulinum toxin type A (Chongqing Claruvis Pharmaceutical Co., Ltd., Chongqing, China), in the treatment of moderate-to-severe glabellar lines. Methods: In this multicenter, randomized, double-blind, vehicle- and active-controlled Phase III trial, 529 adults aged 18-65 with moderate to severe glabellar lines were randomized 4:2:1 to receive a single 20 U injection of YY001, Botox®(Allergan Pharmaceuticals Ireland, Westport, Ireland), or vehicle. The primary endpoint was composite response rate (CRR) at Week 4, defined as a ≥2-grade improvement of glabellar line severity assessed by both investigator and participant. Secondary endpoints included onset time, duration, satisfaction, and safety. Results: YY001 achieved a CRR of 86.7% at Week 4, significantly outperforming Botox® (66.7%, P < .0001) and vehicle (1.3%, P < .0001). It showed faster onset, longer median duration (97 days), and high participant satisfaction. Adverse events were mild and comparable across groups. Only one case of anti-drug antibody was observed; no neutralizing antibodies were detected. A 12-week follow-up and ethnically homogenous population may limit generalizability. Conclusions: YY001 demonstrated strong efficacy and a favorable safety profile than Botox®. Longer-term and multicenter studies are needed to assess durability, immunogenicity, and applicability across broader populations. Level of Evidence: 1 (Therapeutic): For image description, please refer to the figure legend and surrounding text.

Original languageEnglish
Pages (from-to)672-679
Number of pages8
JournalAesthetic Surgery Journal
Volume46
Issue number6
DOIs
StatePublished - Dec 2022
Externally publishedYes

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