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Comparison of the efficacy and safety of three Iran-made botulinum toxin type A products in improving moderate to severe glabellar lines
Aniseh Samadi, Mansour Nassiri Kashani, Azin Ayatollahi, Hamed Zartab, Maryam Ahmadi, Taraneh Yazcanparast, Alireza Firooz,
Volume 16, Issue 3 (11-2025)
Abstract
Background and aim: In recent years, increasing demand for aesthetic treatments in Iran and the need for high-quality domestic products have encouraged several companies to produce botulinum toxin type A. This study aimed to evaluate and compare the clinical efficacy and safety of three such Iranian products.
Methods: In the first part of the study, the overall efficacy of the botulinum toxin type A products for treating glabellar lines was assessed in 230 participants who received one of the three Iranian formulations (mean age 42.69 ± 9.21 years), and compared with 230 participants who received the standard treatment (Dysport®) (mean age 42.50±9.79 years). Outcomes were evaluated on day 30 post-injection. In the second part, the comparative efficacy of the three domestic products during the same period and their safety profile up to month four post-injection were assessed.
Results: A clinically meaningful response (at least a two-grade improvement in glabellar line severity) was achieved in 68.6% of recipients of the Iranian products, compared with 52.8% of Dysport recipients, demonstrating a statistically significant superiority in equivalence studies (P<0.01). Among the three domestic products, only product No. 2 showed a significantly higher proportion of participants achieving ≥2-grade improvement (assessed by an independent physician). The type and frequency of adverse events (except for headache) were comparable to the standard drug monograph.
Conclusion: The findings indicate acceptable efficacy and safety of Iran-made botulinum toxin type A products compared with the reference product. Except for limited differences, the efficacy and safety profiles of the three formulations were generally similar up to day 30 post-injection.
Evaluation of treatment response to dysport Botulinum Toxin based on different glabellar frown line patterns
Aniseh Samadi, Mansour Nassiri Kashani, Azin Ayatollahi, Hamed Zartab, Hasti Ahmadian Yazdi, Taraneh Yazdanparast, Alireza Firooz,
Volume 16, Issue 4 (2-2026)
Abstract

Background and aim: Pattern-based approaches for botulinum toxin injection in the glabellar region have been proposed to optimize treatment outcomes according to individual muscular contraction patterns. However, evidence regarding the necessity of modifying injection techniques based on these patterns remains inconsistent. This study compared the efficacy of a standardized 3-point abobotulinumtoxinA (Dysport®) injection technique among different glabellar contraction patterns in an Iranian population.
 

Methods: A total of 224 Iranian patients with moderate-to-severe glabellar lines were included. Patients were classified into five glabellar contraction patterns: U, V, Omega, Inverted V, and Converging Arrow. All participants received 40–60 IU of Dysport using the same 3-point injection technique. Clinical efficacy was assessed 30 days after treatment using the Glabellar Line Severity Scale (GLSS) based on live investigator assessment, independent evaluator assessment, and patient self-assessment. Treatment response was defined as a≥2-point reduction in glabellar line severity during maximum frown.
 

Results: No significant differences were observed among groups regarding age, sex distribution, or onset of treatment response (P>0.05). Patients with the Inverted V pattern received significantly higher toxin doses than those with U and V patterns (P=0.039 and P=0.031, respectively). Response rates based on live assessment, independent assessment, and patient self-assessment showed no statistically significant differences among contraction patterns (P=0.371, P=0.113, and P=0.360, respectively).
 

Conclusion: Glabellar contraction patterns did not significantly affect short-term clinical response to a standardized 3-point Dysport injection technique, suggesting that complex pattern-based injection modifications may not be necessary for satisfactory early outcomes.


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