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Forehead RhytidesPhase 4NCT03799484

Botulinum Toxin Type A Injection After Topical Anesthesia Versus Petrolatum Ointment

A Phase 4 study testing Botulinum toxin type A, 2.5% lidocaine/2.5% prilocaine and petrolatum ointment in people with Forehead Rhytides and Forehead Wrinkles, run by The University of Texas Health Science Center, Houston at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to determine whether there is a difference in clinical effect, duration of effect, level of discomfort and patient satisfaction in patients receiving topical anesthesia on one side of the forehead and petrolatum ointment on the other prior to Botulinum Toxin Type A administration for the… Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Conditions the study is for
Forehead Rhytides, Forehead Wrinkles
What is being tested?
Botulinum toxin type A, 2.5% lidocaine/2.5% prilocaine and petrolatum ointment
Could I receive a placebo?
No, everyone receives an active treatment
How many people
14 participants
Where
1 siteUnited States
Study dates
4 Jan 2019to 14 Jun 2019
Phase
Phase 4
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • 18 to 65 years of age
  • Presence of horizontal forehead rhytides
  • Good eyebrow excursion (greater than or equal to 5 mm)
  • Able to understand and sign an informed consent form that has been approved by the Committee for the Protection of Human Subjects

Who cannot join

  • Previous injection of botulinum toxin in the intended treatment area for the study within the last 4 months
  • Known allergy to botulinum toxin
  • Known history of sensitivity to local anesthetics of the amide type
  • Existing disorder of neuromuscular transmission
  • Usage of medication with effect on neuromuscular function
  • Women of childbearing potential (who are not postmenopausal for at least 1 year or surgically sterile), who are pregnant or nursing or intend to become pregnant during the time of the study
  • Significant brow asymmetry (> 5mm)
  • Unable to follow-up for the duration of the study (16 weeks)

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Robert Cizik Eye Clinic

    Houston, Texas, 77030

Other trials in United States

About this study

Official title: Randomized, Single Center, Masked Study Comparing the Efficacy of Botulinum Toxin Type A Injection After Topical Anesthesia Versus Petrolatum Ointment

The purpose of this study is to determine whether there is a difference in clinical effect, duration of effect, level of discomfort and patient satisfaction in patients receiving topical anesthesia on one side of the forehead and petrolatum ointment on the other prior to Botulinum Toxin Type A administration for the treatment of forehead rhytides.

Read the detailed description

This is a prospective, randomized, double-masked, comparative study in patients who present at the Robert Cizik Eye Clinic with horizontal forehead rhytides requiring treatment with botulinum toxin Type A (Botox ®; Allergan, Irvine, CA, USA).

The objective of this study is to determine whether there is a difference in clinical effect (weakness/paralysis of the frontalis muscle), duration of effect, level of discomfort and patient satisfaction in patients receiving topical anesthesia (2.5% lidocaine/2.5 % prilocaine cream, Impax Laboratories, LLC) on one side of the forehead and petrolatum ointment on the other prior to BTX-A administration for the treatment of forehead rhytides.

  • Primary outcome variable is change of eyebrow excursion on each side of the forehead from baseline to each follow-up visit.
  • Secondary outcome variables
  • Duration of effect, defined as the elapsed time from injection to the end of botulinum, such that return of baseline frontalis function, i.e. within 2 mm of baseline value
  • Perception of pain immediately after injection at each side
  • Patient satisfaction for each side
  • Patient's perception of difference in efficacy
Being tested
Botulinum toxin type A, 2.5% lidocaine/2.5% prilocaine, petrolatum ointment
Keywords
Rhytides, Forehead Wrinkles

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Botulinum toxin type ADrug

    Also called BTX-A

    Botulinum toxin type A will be administered to both sides

  • 2.5% lidocaine/2.5% prilocaineDrug

    Also called EMLA

    2.5% lidocaine/2.5% prilocaine will be applied to one side of the forehead

  • petrolatum ointmentDevice

    Also called Aquaphor

    petrolatum ointment will be applied to one side of the forehead

Study groups in NCT03799484
Study groupRoleWhat they receive
Topical AnesthesiaOther2.5% Lidocaine/2.5% Prilocaine Cream will be applied to one side of the forehead and Petrolatum Ointment to the other prior to administration of Botulinum Toxin Type A Injection
Receives: Drug: Botulinum toxin type A; Drug: 2.5% lidocaine/2.5% prilocaine
PetrolatumOtherPetrolatum Ointment will be applied to one side of the forehead and 2.5% Lidocaine/2.5% Prilocaine Cream to the other side prior to administration of Botulinum Toxin Type A Injection
Receives: Drug: Botulinum toxin type A; Device: petrolatum ointment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Eyebrow Excursion

    Participants will be asked to raise the brows, and the excursion of the brow from resting position to maximum elevation will be measured in millimeters.

    Measured: Baseline

  2. Eyebrow Excursion

    Participants will be asked to raise the brows, and the excursion of the brow from resting position to maximum elevation will be measured in millimeters.

    Measured: Week 2

  3. Eyebrow Excursion

    Participants will be asked to raise the brows, and the excursion of the brow from resting position to maximum elevation will be measured in millimeters.

    Measured: Week 6

  4. Eyebrow Excursion

    Measured: week 16

Secondary outcomes (14)
  1. Duration of Botulinum Toxin Type A Effect

    Loss of Botulinum Toxin Type A effect is defined as return of baseline frontalis muscle function (function prior to injection) as indicated by eyebrow excursion measurement within 2 millimeters of baseline value.

    Measured: week 16

  2. Perception of Pain Immediately After Injection as Assessed by a Visual Analogue Scale

    A visual analogue scale will be used to assess pain. The scale ranges from 0 (no pain) to 10 (the worse pain possible), with lower scores indicating a better outcome.

    Measured: Immediately after botox injection

  3. Participant Satisfaction With Overall Appearance of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 2

  4. Participant Satisfaction With Overall Appearance of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 6

  5. Participant Satisfaction With Overall Appearance of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 16

  6. Participant Satisfaction With Appearance of Right Side of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 2

  7. Participant Satisfaction With Appearance of Right Side of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 6

  8. Participant Satisfaction With Appearance of Right Side of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 16

  9. Participant Satisfaction With Appearance of Left Side of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 2

  10. Participant Satisfaction With Appearance of Left Side of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 6

  11. Participant Satisfaction With Appearance of Left Side of Forehead as Assessed by a Patient Satisfaction Survey

    The survey will be assessed using a rating scale with the following categories: very satisfied, satisfied, neutral, dissatisfied, and very dissatisfied.

    Measured: Week 16

  12. Number of Participants Who Perceive a Difference in Efficacy Between the 2 Sides of Their Face

    Participants will be asked if there is a noticeable difference between the 2 sides of their face.

    Measured: Week 2

  13. Number of Participants Who Perceive a Difference in Efficacy Between the 2 Sides of Their Face

    Participants will be asked if there is a noticeable difference between the 2 sides of their face.

    Measured: Week 6

  14. Number of Participants Who Perceive a Difference in Efficacy Between the 2 Sides of Their Face

    Participants will be asked if there is a noticeable difference between the 2 sides of their face.

    Measured: Week 16

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Jan 2019
  2. Study start4 Jan 2019
  3. Primary completion14 Jun 2019
  4. Study completion14 Jun 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Other
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
14 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03799484
Sponsor's protocol ID
HSC-MS-18-0908
Status last verified
Jun 2020
First submitted
3 Jan 2019
Last updated
18 Jun 2020
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Scott AB. Botulinum toxin injection into extraocular muscles as an alternative to strabismus surgery. J Pediatr Ophthalmol Strabismus. 1980 Jan-Feb;17(1):21-5. doi: 10.3928/0191-3913-19800101-06.

    PubMed 7365644
  • Carruthers A, Carruthers J. Clinical indications and injection technique for the cosmetic use of botulinum A exotoxin. Dermatol Surg. 1998 Nov;24(11):1189-94. doi: 10.1111/j.1524-4725.1998.tb04097.x.

    PubMed 9834738
  • Carter SR, Seiff SR. Cosmetic botulinum toxin injections. Int Ophthalmol Clin. 1997 Summer;37(3):69-79. doi: 10.1097/00004397-199703730-00006. No abstract available.

    PubMed 9279643
  • Charles PD. Botulinum neurotoxin serotype A: a clinical update on non-cosmetic uses. Am J Health Syst Pharm. 2004 Nov 15;61(22 Suppl 6):S11-23. doi: 10.1093/ajhp/61.suppl_6.S11.

    PubMed 15598005
  • Carruthers A, Carruthers J. Aesthetic indications for botulinum toxin injections. Plast Reconstr Surg. 1995 Feb;95(2):427-8. doi: 10.1097/00006534-199502000-00049. No abstract available.

    PubMed 7824641
  • Clark RP, Berris CE. Botulinum toxin: a treatment for facial asymmetry caused by facial nerve paralysis. Plast Reconstr Surg. 1989 Aug;84(2):353-5.

    PubMed 2748749
  • Sami MS, Soparkar CN, Patrinely JR, Hollier LM, Hollier LH. Efficacy of botulinum toxin type a after topical anesthesia. Ophthalmic Plast Reconstr Surg. 2006 Nov-Dec;22(6):448-52. doi: 10.1097/01.iop.0000248989.33572.3c.

    PubMed 17117100
  • Gordin EA, Luginbuhl AL, Ortlip T, Heffelfinger RN, Krein H. Subcutaneous vs intramuscular botulinum toxin: split-face randomized study. JAMA Facial Plast Surg. 2014 May-Jun;16(3):193-8. doi: 10.1001/jamafacial.2013.2458.

    PubMed 24699554
  • Li Y, Dong W, Wang M, Xu N. Investigation of the Efficacy and Safety of Topical Vibration Anesthesia to Reduce Pain From Cosmetic Botulinum Toxin A Injections in Chinese Patients: A Multicenter, Randomized, Self-Controlled Study. Dermatol Surg. 2017 Dec;43 Suppl 3:S329-S335. doi: 10.1097/DSS.0000000000001349.

    PubMed 29016544
  • Shi LL, Sargen MR, Chen SC, Arbiser JL, Pollack BP. Effective local anesthesia for onabotulinumtoxin A injections to treat hyperhidrosis associated with traumatic amputation. Dermatol Online J. 2016 Jun 15;22(6):13030/qt38b203d0.

    PubMed 27617615
  • Baumann LS, Grunebaum L, Elsaie ML, Murdock J, Jablonka E, Figueras K, Bell M. Safety and efficacy of a rapid-acting topical 4% lidocaine gel in a unique drug delivery system. J Drugs Dermatol. 2010 Dec;9(12):1500-4.

    PubMed 21120257
  • Weiss RA, Lavin PT. Reduction of pain and anxiety prior to botulinum toxin injections with a new topical anesthetic method. Ophthalmic Plast Reconstr Surg. 2009 May-Jun;25(3):173-7. doi: 10.1097/IOP.0b013e3181a145ca.

    PubMed 19454924
  • Alam M, Bolotin D, Carruthers J, Hexsel D, Lawrence N, Minkis K, Ross EV. Consensus statement regarding storage and reuse of previously reconstituted neuromodulators. Dermatol Surg. 2015 Mar;41(3):321-6. doi: 10.1097/DSS.0000000000000303.

    PubMed 25705950
  • Carruthers J, Fagien S, Matarasso SL; Botox Consensus Group. Consensus recommendations on the use of botulinum toxin type a in facial aesthetics. Plast Reconstr Surg. 2004 Nov;114(6 Suppl):1S-22S. doi: 10.1097/01.PRS.0000144795.76040.D3.

    PubMed 15507786
  • Ito H, Ito H, Nakano S, Kusaka H. Low-dose subcutaneous injection of botulinum toxin type A for facial synkinesis and hyperlacrimation. Acta Neurol Scand. 2007 Apr;115(4):271-4. doi: 10.1111/j.1600-0404.2006.00746.x.

    PubMed 17376126

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Botulinum toxin type A, 2.5% lidocaine/2.5% prilocaine and petrolatum ointment in people with Forehead Rhytides and Forehead Wrinkles, run by The University of Texas Health Science Center, Houston at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 18 Jun 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 18 Jun 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Eyebrow Excursion (time frame: Baseline). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03799484, which also lists 16 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jun 2020.

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