Trial Outcomes & Findings for RHA®4 for Midface Volume Deficiency (NCT NCT05133739)

NCT ID: NCT05133739

Last Updated: 2025-03-18

Results Overview

A change in the TMVDS ≥1 grade compared to pretreatment will be considered clinically meaningful. In order to confirm sensitivity 8 weeks after the last treatment: the proportion of responders with a ≥1-grade point on the TMVDS scale for Comparator product 8 weeks after the last treatment when compared to Baseline must be ≥70%. The TMVDS is a validated 5-point scale for assessing midface volume deficit. Possible scores range from 0 (Absent) to 4 (Very Severe).

Recruitment status

COMPLETED

Target enrollment

201 participants

Primary outcome timeframe

8 weeks after the last treatment

Results posted on

2025-03-18

Participant Flow

Participant milestones

Participant milestones
Measure
RHA®4
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Overall Study
STARTED
152
49
Overall Study
ITT Population
152
49
Overall Study
PP Population
131
42
Overall Study
COMPLETED
126
43
Overall Study
NOT COMPLETED
26
6

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

RHA®4 for Midface Volume Deficiency

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
RHA®4
n=152 Participants
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=49 Participants
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Total
n=201 Participants
Total of all reporting groups
Age, Continuous
55.4 years
STANDARD_DEVIATION 9.97 • n=5 Participants
55.6 years
STANDARD_DEVIATION 7.85 • n=7 Participants
55.5 years
STANDARD_DEVIATION 9.48 • n=5 Participants
Sex: Female, Male
Female
134 Participants
n=5 Participants
46 Participants
n=7 Participants
180 Participants
n=5 Participants
Sex: Female, Male
Male
18 Participants
n=5 Participants
3 Participants
n=7 Participants
21 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
18 Participants
n=5 Participants
6 Participants
n=7 Participants
24 Participants
n=5 Participants
Race (NIH/OMB)
White
130 Participants
n=5 Participants
42 Participants
n=7 Participants
172 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Region of Enrollment
United States
152 participants
n=5 Participants
49 participants
n=7 Participants
201 participants
n=5 Participants
Fitzpatrick Skin Type
Type I-III
107 Participants
n=5 Participants
36 Participants
n=7 Participants
143 Participants
n=5 Participants
Fitzpatrick Skin Type
Type IV-VI
45 Participants
n=5 Participants
13 Participants
n=7 Participants
58 Participants
n=5 Participants

PRIMARY outcome

Timeframe: 8 weeks after the last treatment

Population: Primary endpoint on the PP population

A change in the TMVDS ≥1 grade compared to pretreatment will be considered clinically meaningful. In order to confirm sensitivity 8 weeks after the last treatment: the proportion of responders with a ≥1-grade point on the TMVDS scale for Comparator product 8 weeks after the last treatment when compared to Baseline must be ≥70%. The TMVDS is a validated 5-point scale for assessing midface volume deficit. Possible scores range from 0 (Absent) to 4 (Very Severe).

Outcome measures

Outcome measures
Measure
RHA®4
n=131 Participants
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=42 Participants
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Non-inferiority of RHA®4 to the Change From Baseline for Subjects Treated With Comparator Product at 8 Weeks After the Last Treatment as Assessed by the BLE Using the Teoxane Midface Volume Deficit Scale (TMVDS).
-1.3 score on a scale
Standard Deviation 0.80
-1.3 score on a scale
Standard Deviation 0.65

SECONDARY outcome

Timeframe: Week 24, 52 after last treatment, week 12 after re-treatment

Population: ITT Population

A change in the TMVDS ≥1 grade compared to pre-treatment will be considered clinically meaningful. The TMVDS is a validated 5-point static scale for assessing midface volume deficit. Possible scores range from 0 (Absent) to 4 (Very Severe).

Outcome measures

Outcome measures
Measure
RHA®4
n=152 Participants
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=49 Participants
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Change From Baseline in TMVDS Score as Assessed by the BLE at 24 and 52 Weeks After Last Treatment,and Weeks After Re-treatment if Applicable.
Week 24 after last treatment
-1.1 score on a scale
Standard Deviation 0.79
-1.0 score on a scale
Standard Deviation 0.76
Change From Baseline in TMVDS Score as Assessed by the BLE at 24 and 52 Weeks After Last Treatment,and Weeks After Re-treatment if Applicable.
Week 52 after last treatment
-0.9 score on a scale
Standard Deviation 0.79
-0.8 score on a scale
Standard Deviation 0.69
Change From Baseline in TMVDS Score as Assessed by the BLE at 24 and 52 Weeks After Last Treatment,and Weeks After Re-treatment if Applicable.
Re-treatment: 12 weeks post re-treatment
-1.1 score on a scale
Standard Deviation 0.91
-1.2 score on a scale
Standard Deviation 0.69

SECONDARY outcome

Timeframe: Week 8, 24, 52 after last treatment, week 12 after re-treatment

Population: ITT Population

he Global Aesthetic Improvement (GAI) is a subjective, balanced, 5-point dynamic scale assessing cosmetic improvement. Possible scores range from "much improved", "improved", "no change", "worse", to "much worse".

Outcome measures

Outcome measures
Measure
RHA®4
n=152 Participants
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=49 Participants
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Number of Subjects Scored Either "Much Improved" or "Improved" on Global Aesthetic Improvement (GAI) Scale by the BLE.
Week 8 after last treatment
129 Participants
44 Participants
Number of Subjects Scored Either "Much Improved" or "Improved" on Global Aesthetic Improvement (GAI) Scale by the BLE.
Week 24 after last treatment
111 Participants
37 Participants
Number of Subjects Scored Either "Much Improved" or "Improved" on Global Aesthetic Improvement (GAI) Scale by the BLE.
Week 52 after last treatment
97 Participants
30 Participants
Number of Subjects Scored Either "Much Improved" or "Improved" on Global Aesthetic Improvement (GAI) Scale by the BLE.
Re-treatment: 12 weeks post re-treatment
63 Participants
26 Participants

SECONDARY outcome

Timeframe: Change from Baseline at Weeks 8, 24, 52 after last treatment,12 weeks after re-treatment

Population: ITT population

The FACE-Q measures the experience and outcomes of aesthetic facial procedures from the patient's perspective. The FACE-Q questionnaire is composed of 5 questions with a score linked to answers (1 being "Very Dissatisfied" and 4 being "Very Satisfied"). To calculate the FACE-Q score, outcomes from all 5 questions were pooled, data were transformed so that higher scores reflected a superior (positive) outcome, and adapted to a scale of 100 units (i.e. worst/lowest score = 0, best/highest score = 100).

Outcome measures

Outcome measures
Measure
RHA®4
n=152 Participants
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=49 Participants
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Subject's Perception of Treatment Effectiveness as Per the "Satisfaction With Cheeks" FACE-Q Scale Questionnaire at Each Visit, at Rest.
Re-treatment: 12 weeks post re-treatment
50.8 score on a scale
Standard Deviation 29.97
59.3 score on a scale
Standard Deviation 21.76
Subject's Perception of Treatment Effectiveness as Per the "Satisfaction With Cheeks" FACE-Q Scale Questionnaire at Each Visit, at Rest.
Week 8 after last treatment
53.0 score on a scale
Standard Deviation 27.15
49.5 score on a scale
Standard Deviation 27.20
Subject's Perception of Treatment Effectiveness as Per the "Satisfaction With Cheeks" FACE-Q Scale Questionnaire at Each Visit, at Rest.
Week 24 after last treatment
48.0 score on a scale
Standard Deviation 27.65
52.5 score on a scale
Standard Deviation 23.48
Subject's Perception of Treatment Effectiveness as Per the "Satisfaction With Cheeks" FACE-Q Scale Questionnaire at Each Visit, at Rest.
Week 52 after last treatment
38.6 score on a scale
Standard Deviation 28.85
38.1 score on a scale
Standard Deviation 31.07

SECONDARY outcome

Timeframe: Change from Baseline at Weeks 8, 24, 52 after last treatment and 12 week after re-treatment.

Population: ITT population

The FACE-Q measures the experience and outcomes of aesthetic facial procedures from the patient's perspective. The FACE-Q questionnaire is composed of 5 questions with a score linked to answers (1 being "Very Dissatisfied" and 4 being "Very Satisfied"). To calculate the FACE-Q score, outcomes from all 5 questions were pooled, data were transformed so that higher scores reflected a superior (positive) outcome, and adapted to a scale of 100 units (i.e. worst/lowest score = 0, best/highest score = 100).

Outcome measures

Outcome measures
Measure
RHA®4
n=152 Participants
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=49 Participants
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Subject's Perception of Treatment Effectiveness as Per the "Satisfaction With Cheeks" FACE-Q Scale Questionnaire at Each Visit, When Smiling
Week 8 after last treatment
56.1 score on a scale
Standard Deviation 27.67
51.3 score on a scale
Standard Deviation 29.79
Subject's Perception of Treatment Effectiveness as Per the "Satisfaction With Cheeks" FACE-Q Scale Questionnaire at Each Visit, When Smiling
Week 24 after last treatment
49.5 score on a scale
Standard Deviation 29.33
53.2 score on a scale
Standard Deviation 26.68
Subject's Perception of Treatment Effectiveness as Per the "Satisfaction With Cheeks" FACE-Q Scale Questionnaire at Each Visit, When Smiling
Re-treatment: 12 weeks post re-treatment
53.1 score on a scale
Standard Deviation 28.43
58.2 score on a scale
Standard Deviation 21.87
Subject's Perception of Treatment Effectiveness as Per the "Satisfaction With Cheeks" FACE-Q Scale Questionnaire at Each Visit, When Smiling
Week 52 after last treatment
39.6 score on a scale
Standard Deviation 29.78
41.5 score on a scale
Standard Deviation 31.84

SECONDARY outcome

Timeframe: Week 8, 24, 52 after last treatment, week 12 after re-treatment

Population: ITT population

The Subject Satisfaction Scale is a subjective, balanced, 5-point scale assessing subject satisfaction with study treatment. Possible scores range from with 1 (very satisfied) to 5 (very dissatisfied).

Outcome measures

Outcome measures
Measure
RHA®4
n=152 Participants
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=49 Participants
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Number of Subjects "Satisfied" or "Very Satisfied" With Study Treatment Using the Subject Satisfaction Scale at Weeks 8, 24, 52 After Last Treatment and 12 Weeks After Re-treatment.
Week 8 after last treatment
123 Participants
43 Participants
Number of Subjects "Satisfied" or "Very Satisfied" With Study Treatment Using the Subject Satisfaction Scale at Weeks 8, 24, 52 After Last Treatment and 12 Weeks After Re-treatment.
Week 24 after last treatment
119 Participants
39 Participants
Number of Subjects "Satisfied" or "Very Satisfied" With Study Treatment Using the Subject Satisfaction Scale at Weeks 8, 24, 52 After Last Treatment and 12 Weeks After Re-treatment.
Week 52 after last treatment
106 Participants
38 Participants
Number of Subjects "Satisfied" or "Very Satisfied" With Study Treatment Using the Subject Satisfaction Scale at Weeks 8, 24, 52 After Last Treatment and 12 Weeks After Re-treatment.
Re-treatment: 12 weeks post re-treatment
73 Participants
28 Participants

Adverse Events

RHA®4

Serious events: 1 serious events
Other events: 36 other events
Deaths: 0 deaths

Comparator Device

Serious events: 3 serious events
Other events: 8 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
RHA®4
n=152 participants at risk
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=49 participants at risk
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Injury, poisoning and procedural complications
COMPLICATIONS FROM HERNIA REPAIR SURGERY
0.00%
0/152 • 52 to 64 (for patients receiving re-treatment) weeks
2.0%
1/49 • Number of events 1 • 52 to 64 (for patients receiving re-treatment) weeks
Infections and infestations
COVID-19 INFECTION
0.66%
1/152 • Number of events 1 • 52 to 64 (for patients receiving re-treatment) weeks
0.00%
0/49 • 52 to 64 (for patients receiving re-treatment) weeks
Nervous system disorders
TRANSIENT ISCHEMIC ATTACK
0.00%
0/152 • 52 to 64 (for patients receiving re-treatment) weeks
2.0%
1/49 • Number of events 1 • 52 to 64 (for patients receiving re-treatment) weeks
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
P16 POSITIVE OROPHARYNGEAL CANCER
0.00%
0/152 • 52 to 64 (for patients receiving re-treatment) weeks
2.0%
1/49 • Number of events 1 • 52 to 64 (for patients receiving re-treatment) weeks

Other adverse events

Other adverse events
Measure
RHA®4
n=152 participants at risk
injection of RHA®4 in Midface: RHA® 4 is a sterile, biodegradable, biocompatible, viscoelastic, clear, colorless, homogenized gel implant. It consists of cross-linked hyaluronic acid produced by fermentation of Streptococcus equi bacteria, formulated to a concentration of 23 mg/mL and 0.3% w/w lidocaine in a physiologic buffer. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
Comparator Device
n=49 participants at risk
injection of Comparator Product in Midface: Comparator product is sterile, biodegradable, colorless gel of hyaluronic acid generated by Streptococcus species of bacteria, chemically crosslinked with BDDE. Up to 3.0 mL injected per cheek (subcutaneous and/or supraperiosteal layer). Touch-up treatment provided at 4 weeks (up to 3.0 mL per cheek).
General disorders
Injection Site Mass
11.2%
17/152 • 52 to 64 (for patients receiving re-treatment) weeks
6.1%
3/49 • 52 to 64 (for patients receiving re-treatment) weeks
General disorders
Injection Site Induration
5.3%
8/152 • 52 to 64 (for patients receiving re-treatment) weeks
10.2%
5/49 • 52 to 64 (for patients receiving re-treatment) weeks
General disorders
Injection Site Pain
3.3%
5/152 • 52 to 64 (for patients receiving re-treatment) weeks
2.0%
1/49 • 52 to 64 (for patients receiving re-treatment) weeks
General disorders
Injection Site Discoloration
3.3%
5/152 • 52 to 64 (for patients receiving re-treatment) weeks
0.00%
0/49 • 52 to 64 (for patients receiving re-treatment) weeks
Nervous system disorders
Headache
13.8%
21/152 • 52 to 64 (for patients receiving re-treatment) weeks
10.2%
5/49 • 52 to 64 (for patients receiving re-treatment) weeks
Infections and infestations
Covid-19
5.9%
9/152 • 52 to 64 (for patients receiving re-treatment) weeks
6.1%
3/49 • 52 to 64 (for patients receiving re-treatment) weeks
Infections and infestations
Nasopharyngitis
2.0%
3/152 • 52 to 64 (for patients receiving re-treatment) weeks
4.1%
2/49 • 52 to 64 (for patients receiving re-treatment) weeks

Additional Information

Clinical Research Scientist

TEOXANE SA

Phone: +41(0) 22 344 96 36

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60