Botulinum Toxin Type A Injection After Topical Anesthesia Versus Petrolatum Ointment

NCT ID: NCT03799484

Last Updated: 2020-06-18

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

14 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-04

Study Completion Date

2019-06-14

Brief Summary

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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.

Detailed Description

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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

Conditions

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Forehead Rhytides Forehead Wrinkles

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Outcome Assessors
Randomization will only be known by the principal investigator performing the injections and will not be disclosed to the participants or the brow excursion examiner.

Study Groups

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Topical Anesthesia

2.5% 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

Group Type OTHER

Botulinum toxin type A

Intervention Type DRUG

Botulinum toxin type A will be administered to both sides

2.5% lidocaine/2.5% prilocaine

Intervention Type DRUG

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

Petrolatum

Petrolatum 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

Group Type OTHER

Botulinum toxin type A

Intervention Type DRUG

Botulinum toxin type A will be administered to both sides

petrolatum ointment

Intervention Type DEVICE

petrolatum ointment will be applied to one side of the forehead

Interventions

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Botulinum toxin type A

Botulinum toxin type A will be administered to both sides

Intervention Type DRUG

2.5% lidocaine/2.5% prilocaine

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

Intervention Type DRUG

petrolatum ointment

petrolatum ointment will be applied to one side of the forehead

Intervention Type DEVICE

Other Intervention Names

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BTX-A EMLA Aquaphor

Eligibility Criteria

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Inclusion Criteria

* 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

Exclusion Criteria

* 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)
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Robert Cizik Eye Clinic

OTHER

Sponsor Role collaborator

The University of Texas Health Science Center, Houston

OTHER

Sponsor Role lead

Responsible Party

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Karina Richani-Reverol

Clinical Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Karina Richani-Reverol, MD

Role: PRINCIPAL_INVESTIGATOR

The University of Texas Health Science Center, Houston

Locations

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Robert Cizik Eye Clinic

Houston, Texas, United States

Site Status

Countries

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United States

References

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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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
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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.

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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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
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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.

Reference Type BACKGROUND
PMID: 27617615 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 21120257 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 19454924 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 25705950 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 15507786 (View on PubMed)

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.

Reference Type BACKGROUND
PMID: 17376126 (View on PubMed)

Tzou CH, Giovanoli P, Ploner M, Frey M. Are there ethnic differences of facial movements between Europeans and Asians? Br J Plast Surg. 2005 Mar;58(2):183-95. doi: 10.1016/j.bjps.2004.10.014.

Reference Type BACKGROUND
PMID: 15710113 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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HSC-MS-18-0908

Identifier Type: -

Identifier Source: org_study_id

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