A Comparison of Neurotoxin Protein per Glabellar Dose

Botulinum toxin type A is widely used in aesthetics to prevent the muscle contraction that leads to wrinkles. In terms of the glabella specifically, a team of researchers reported a systematic analysis of total protein and pure neurotoxin protein for the FDA approved dose in a poster presented at Cosmetic Surgery Forum 2019, held last December in Nashville, Tenn.

According to authors Tiffany Alexander, M.D., and Ania Ginter, M.D., Duke University Medical Center, “These proportion loads are usually described per vial which can be confusing to the injector.”

To make an effectual comparison, they conducted a literature search in August 2019 using the search terms “botulinum content,” “botulinum preparation,” “prabotulinum” and “daxibotulinumtoxinA.” The search returned 674 articles that included numerical values of clostridial protein content, neurotoxin protein load and specific biologic activity of the botulinum toxins, according to the poster.

Noting the similarities and differences in botulinum toxin type A products, where onabotulinumtoxinA (ONA), abobotulinumtoxinA (ABO) and prabotulinumtoxinA-xvfs (PRABO) are composed of clostidium botulinum toxin type A and non-HA proteins, incobotulinumtoxinA (INCO) is clostridium botulinum toxin type A only, and daxibotuliniumtoxinA (DAXI) includes clostridium botulinum toxin type A plus a proprietary peptide, the researchers were able to identify the neurotoxin protein per aesthetic dose injected as indicated in the chart below.