Amir Moradi

Shahid Beheshti University of Medical Sciences

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John Joseph

Beverly Hills Cardiology

Nehzat Akiash

Ahvaz Jundishapur University of Medical Sciences

Erfan Ghadirzadeh

Mazandaran University of Medical Sciences

Sue Ellen Cox

University of North Carolina at Chapel Hill

Somayeh Abbaspour

Ahvaz Jundishapur University of Medical Sciences

Joely Kaufman‐Janette

Skin Cancer Foundation

Jeanette Poehler

Creative Commons

Z. Paul Lorenc

Aesthetic Surgery Center

Steven Dayan

University of Illinois Chicago

Glynis Ablon

Ablon Skin Institute and Research Center

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Shahid Beheshti University of Medical Sciences

Tehran University of Medical Sciences

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Galderma (United States)

Ahvaz Jundishapur University of Medical Sciences

Mazandaran University of Medical Sciences

Shahid Beheshti University

University of British Columbia

University of California, Irvine

Tabriz University of Medical Sciences

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Subject satisfaction and psychological well‐being with escalating abobotulinumtoxinA injection dose for the treatment of moderate to severe glabellar lines

Journal of Cosmetic Dermatology (2022)

Steven Dayan John Joseph Amir Moradi Z. Paul Lorenc Kyle Coleman

Previous studies indicate that the efficacy and durability of a single AbobotulinumtoxinA (ABO) treatment for moderate to severe glabellar lines may be enhanced with increasing dose, while safety outcomes remain consistent with those of the licensed dose (50 U).Evaluation of subject-reported indicators of treatment efficacy, satisfaction, and psychological well-being with ABO dose escalation.A Phase 2, 36-week, multicenter, randomized, dose-ranging, double-blind, placebo-controlled study was conducted in adults with moderate to severe glabellar lines. Subjects received a single ABO treatment, dosed at 50, 75, 100, or 125 U, or placebo. Efficacy endpoints comprised subject-assessed improvement in line severity of ≥1-grade from baseline at maximum frown, global aesthetic improvement scale (GAIS) grade, FACE-Q™ appraisal of lines, psychological well-being and age, and subject satisfaction.The study included 399 subjects (88.2% were female). Respective responder rates (≥1-grade improvement) with ABO 50-125 U doses ranged between 96.3%-100% at Week 4, 65.0%-67.9% at Week 24, and 33.8%-44.4% at Week 36. GAIS responder rate and FACE-Q appraisal of lines showed a similar pattern of change. Satisfaction was high and psychological well-being was improved from Week 4 through Week 36, with natural, youthful, and refreshed appearance reported for all ABO doses.A single ABO treatment (dosed at 50-125 U) provided significant and sustained improvements in glabellar line severity over durations up to 36 weeks, versus placebo. Treatment satisfaction was high with all doses. Participants reported natural and youthful appearance, alongside improvements in psychological well-being.

10.1111/jocd.14906

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A Randomized, Comparator-Controlled Study of HARC for Cheek Augmentation and Correction of Midface Contour Deficiencies

Journal of Drugs in Dermatology (2021)

Derek Jones Leslie Baumann Amir Moradi Sachin M. Shridharani Melanie D. Palm

Background: HA RC is a soft and flexible hyaluronic acid filler containing lidocaine, manufactured using XpresHAn ® technology, restoring natural-looking volume and soft contours.Objectives: To evaluate safety and effectiveness of HA RC for cheek augmentation and correction of midface contour deficiencies compared to a control product HA JV (hereafter referred to as Control).Primary objective was to demonstrate non-inferiority of HA RC compared to the Control, by blinded evaluation of change from baseline in midface fullness 12 weeks after last injection, using a 4 grade midface volume scale (MMVS).Materials and Methods: Subjects over the age of 21 with loss of fullness in the midface area (MMVS score 2, 3, or 4) were randomized 2:1 to treatment with HA RC (n=142) or Control (n=68).Optional touch-up was allowed after 4 weeks.Study assessments included MMVS, aesthetic improvement, subject satisfaction, and safety.Subjects were followed for 48 weeks.Results: Overall, most subjects were female (89%) and mean age was 53 years (range 24-80).Total mean volume injected was 4.3 mL for HA RC and 4.9 mL for Control.Primary objective was met; mean change from baseline in MMVS score at week 12: -1.4 (HA RC ), -1.3 (Control), 95% CI: -0.22, 0.06.HA RC effectiveness was supported by a high degree of aesthetic improvement and subject satisfaction throughout 48 weeks.Related adverse events were generally mild and transient.Conclusions: HA RC was well tolerated and non-inferior to Control for correction of midface fullness at 12 weeks after last injection.Aesthetic improvement and subject satisfaction were high and lasted through week 48.

Cheek

10.36849/jdd.6191

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Effectiveness and Safety of Calcium Hydroxylapatite With Lidocaine for Improving Jawline Contour

Journal of Drugs in Dermatology (2021)

Amir Moradi Jeremy Green Joel D. Cohen John Joseph Rada Dakovic

One of the early signs of aging is loss of jawline contour. Not all cases require surgical intervention and soft-tissue augmentation with injectable fillers may restore the profile and youthful appearance of the jawline.To demonstrate the effectiveness and safety of calcium hydroxylapatite with lidocaine [CaHA (+); Radiesse® (+)] to improve the contour of jawline after deep (subdermal and/or supraperiosteal) injection.Healthy eligible patients with moderate or severe ratings on the Merz Jawline Assessment Scale (MJAS) were randomized 2:1 to treatment with CaHA (+) or to control. Patients in the control group remained untreated until week 12, then received delayed treatment. Touch-ups were allowed in both groups, and re-treatment was allowed in the treatment group only. Effectiveness was evaluated on the MJAS, patient and investigator Global Aesthetic Improvement Scales, and FACE-Q™ questionnaires. Adverse events were recorded over a 60-week period.Treatment response rate (≥1-point MJAS improvement) was 93/123 (75.6%) for the treatment group and 5/57 (8.8%) for the control/delayed-treatment group at week 12. The difference between response rates was statistically significant (P<0.0001), showing superiority of treatment over control. Satisfaction with aesthetic improvement was reported by patients and treating investigators throughout the study. A total of 76/113 (67.3%) patients who responded to treatment 12 weeks after initial injection also demonstrated persistent improvement 48 weeks after initial treatment. The study demonstrated a favorable safety profile, with no reported unexpected adverse events.CaHA (+) is a safe and effective treatment for improving the contour of the jawline. J Drugs Dermatol. 2021;20(11): 1231-1238. doi:10.36849/JDD.6442.

Clinical endpoint

10.36849/jdd.6442

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Effectiveness and Safety of Large Gel Particle Hyaluronic Acid With Lidocaine for Correction of Midface Volume Deficit or Contour Deficiency

Dermatologic Surgery (2016)

Robert A. Weiss Amir Moradi David Bank Julius W. Few John Joseph

Aging effects, such as facial flatness, increased tissue laxity, and soft tissue descent and deflation, contribute to midface deficiency.To evaluate whether large gel particle hyaluronic acid with lidocaine (LGP-HAL) is more effective in the treatment of midface deficiencies than no treatment.Subjects with mild to substantial loss of midface fullness were randomized 3:1 to LGP-HAL (Restylane Lyft; Galderma Laboratories, L.P., Fort Worth, TX) or no treatment. Treatment success was defined as at least 1-grade improvement in Medicis Midface Volume Scale (MMVS) on each side of the face at 8 weeks as assessed by a blinded evaluator. Secondary efficacy end points included MMVS score, global aesthetic improvement, and subject satisfaction.Significantly greater percent of subjects achieved treatment success in the LGP-HAL group compared to no treatment at all time points through Month 12 (p < .001). One year after initial treatment, 85% of subjects still had a global aesthetic improvement assessed by the treating investigator. Subject satisfaction demonstrated that LGP-HAL improved the aesthetic appearance of the midface. Most reported adverse events (80%) were mild in severity.The LGP-HAL treatment is well tolerated and provides significant improvement up to 12 months for the correction of midface deficiencies.

Facial Rejuvenation

10.1097/dss.0000000000000771

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STENTING CEREBRAL ARTERIES WITH EMBOLI-PROTECTION DEVICE: REPORT OF 5 CASES AND SIX-MONTH'S FOLLOW-UP

Mahmood Shabestari A A Dadgar T Bostani Amlashi M Talaei Khouei Amir Moradi

BackgroundCarotid endarterectomy is superior to medical management for the prevention of stroke in patients with carotid and vertebral artery stenosis, but stenting with the use of emboli-protection devices is less invasive. We report our results with carotid artery stenting in five patients. MethodsStenting was done in five symptomatic male patients (mean age = 66.8 years), 20% and 40% of whom were diabetic and hypertensive, respectively, and 60% had coronary artery involvement. Indications for stenting were prior stroke in one, vertigo in one and transient ischemic attack in three patients. ResultsStenting with self-expandable stents was technically successful in all the cases. No stroke, restenosis or death occurred. ConclusionStenting cerebral arteries are feasible with a high degree of technical success (Iranian Heart Journal 2005; 6 (1,2): 60-63).

Stroke

Carotid stenting

Coronary arteries

Endarterectomy

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Aesthetic Implantation of Calcium Hydroxylapatite Does Not Interfere With Radiological Assessment of Bones in the Dorsum of the Hands

Aesthetic Surgery Journal (2022)

Amir Moradi Rada Ðaković Gemma Òdena

Abstract Background Calcium hydroxylapatite (CaHA) is a radiopaque dermal filler used to provide volume correction in the dorsum of the hand. Objectives The aim of this study was to evaluate whether CaHA implantation in the dorsum of the hand interferes with radiological assessment by obscuring the bones. Methods This 2-year, prospective, single-center, open-label study enrolled 20 subjects with Merz Hand Grading Scale (MHGS) grades ranging from moderate (MHGS 2 or 3; n = 10) to very severe (MHGS 4; n = 10). All subjects received an initial CaHA treatment and were offered up to 3 retreatments to provide volume correction in the dorsum of the hands, over a period of 18 months. Bone obscuration was assessed by blinded, licensed radiologists responsible for interpreting plain radiographs (X-rays). Results CaHA was seen to be present in 100% of hands in Month 1 X-rays and in 83.3% in Month 24 X-rays, but no bone obscuration was reported in any X-rays at any evaluated time point. Conclusions According to blinded radiologists, treatment with CaHA in the dorsum of the hand does not obscure radiographic assessment of the bones seen on X-rays up to 24 months after initial injection. The safety of CaHA retreatment was also demonstrated by the lack of bone obscuration after multiple retreatments.

Hydroxylapatite

10.1093/asj/sjac344

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A comparison between 64-projection and 32-projection myocardial perfusion scintigraphy

European Heart Journal - Imaging Methods and Practice (2024)

Seyed Mohammad Abedi Erfan Ghadirzadeh Hanie Karimi Pedram Nezhadnaderi Seyede Sepide Daryabari

Abstract Aims While most clinical guidelines recommend using a 64-projection view technique, some protocols do not specify a preference between 32-projection and 64-projection methods for conducting myocardial perfusion scintigraphy (MPS), which shows the lack of consensus in this matter. Nevertheless, these guidelines and protocols have not provided us with compelling evidence to support why the 64-projection technique is usually chosen. Thus, we aimed to determine if there is a significant difference between them in the assessment of cardiac perfusion and functional indices. Methods and results Sixty-nine patients were included in this pilot prospective, cross-sectional, cross-over, same patient control protocol study and underwent 32- and 64-projection MPS at both stress and rest phases after injecting 740–925 MBq of 99mTc-MIBI for every patient. Then, cardiac indices, including summed stress, rest, and difference scores, extent-stress and rest, left ventricular volumes and ejection-fraction, peak filling rate (PFR), and time to peak filling rate (TTPF) were recorded. Lin’s concordance correlation coefficient was used to assess the agreement between protocols, and a paired sample t-test was used to compare the means of variables where appropriate. Findings revealed no significant difference as well as excellent/good agreement between the two methods in either the stress or rest state, except for the TTPF and PFR. Conclusion The findings suggest that lower-projection techniques could be adequate for routine clinical assessments without sacrificing diagnostic accuracy. However, the poor agreement for PFR and TTPF indicates that the 32-projection method may not reliably assess diastolic function, implying that the 64-projection protocol is preferable when precise evaluations are necessary.

Myocardial perfusion scintigraphy

10.1093/ehjimp/qyae142

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A Novel 3-Point Injection Technique for OnabotulinumtoxinA in the Upper Depressor Anguli Oris

Dermatologic Surgery (2023)

Amir Moradi Saami Khalifian Mohammed S. Alghoul Jeanette Poehler

BACKGROUND AND OBJECTIVE To evaluate the efficacy and safety of onabotulinumtoxinA (ONA) injections to the depressor anguli oris (DAO) to improve downturned mouth. PATIENTS AND METHODS/MATERIALS This prospective, placebo-controlled, study enrolled subjects aged 18 to 65 years. Injections were performed using a novel 3-point technique in the upper DAO (1.5 U/injection site). The primary end point was a DAO contraction scale 1-grade improvement. Subjective evaluation was performed using the Global Aesthetic Improvement Scale (GAIS). RESULTS Ten subjects received ONA and 10 placebo (saline) injections. In ONA-treated subjects, DAO scores showed significant improvements at Weeks 4 and 12 ( p < .001) compared with baseline. No significant difference between visits was observed for placebo-injected subjects. Global Aesthetic Improvement Scale scores showed that 100% of subjects were improved compared with baseline at Week 4% and 90% at Week 12. By contrast, 90% and 80% of placebo-treated subjects had “no change” in their DAO appearance at Weeks 4 and 12. Subject GAIS assessments matched the live evaluator at Week 4; 60% continued to report improvement at Week 12. Treatment was well tolerated. CONCLUSION OnabotulinumtoxinA injections to the DAO using a 3-point technique provide clinically meaningful improvements in appearance. Treatment was well tolerated and in most individuals lasted at least 12 weeks. IDENTIFIER ClinicalTrials.gov NCT04240535.

10.1097/dss.0000000000003695

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Long‐term duration and safety of Radiesse (+) for the treatment of jawline

Journal of Cosmetic Dermatology (2024)

Jeremy B. Green Roberta Del Campo Alan J. Durkin David K. Funt Nicole Nasrallah

Abstract Background Calcium hydroxyapatite (CaHA)‐carboxymethylcellulose (CMC)+ has unique properties that make it optimal for lifting, contouring, and defining the jawline. This long‐term follow‐up of a randomized, multicenter, rater‐blinded trial reports efficacy and safety of CaHA‐CMC(+) through 48 and up to 60 weeks post‐treatment. Methods Eligible patients were randomized (2:1) to the treatment or the control/delayed treatment group to receive CaHA‐CMC(+) injections in both jawlines. While touch‐ups were permitted 4 weeks post‐treatment for both groups, only the treatment group was eligible for optional retreatment after 48 weeks. The primary outcome was ≥1‐point improvement on both jawlines on the Merz Jawline Assessment Scale (MJAS); secondary endpoints included the Subject Global Aesthetic Improvement Scale (SGAIS) among others. Post hoc analysis included pooling up to 48‐week data from the combined treatment and control/delayed groups and 60‐week data for the treatment group. Results Overall, 175 received treatment. MJAS responder rates were 77.9%, 78.7%, and 62.9% at 12, 24, and 48 weeks post‐treatment, respectively. Responder rate on the MJAS at 60 weeks was 74.6% for those who received retreatment and 43.5% for those patients who received only the initial and touchup treatments. SGAIS scores demonstrated 93.4%, 85.6%, and 68.5% of patients rated themselves very much improved after 12, 24, and 48 weeks, respectively. Adverse events consisted of procedure or CaHA‐CMC(+)‐related events that were mostly resolved and overwhelmingly mild. Conclusions CaHA‐CMC(+) produced clinically meaningful and long‐lasting improvements in jawline contour and was well tolerated in patients through 60 weeks. Trial Registration ClinicalTrials.gov Identifier: NCT03583359.

Clinical endpoint

Post-hoc analysis

10.1111/jocd.16436

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A 12-month, prospective, evaluator-blinded study of small gel particle hyaluronic acid filler in the correction of temporal fossa volume loss.

PubMed (2013)

Amir Moradi Azadeh Shirazi Jeanette Moradi

The primary objective of this study is to examine the use and persistency of small gel particle hyaluronic acid (SGP-HA) filler (Restylane®; Medicis Aesthetics Inc, Scottsdale, AZ) in the treatment of temporal fossa volumization over a 12-month follow-up, and determine local adverse events (AEs).This is a US Food and Drug Administration-approved, blinded, prospective, single-center, open-label trial enrolling 20 subjects undergoing subcutaneous injection of SGP-HA for rejuvenation of the temples. Primary outcomes were measured using a standardized grading system—the Hollowness Severity Rating Scale (HSRS)—at each visit by the treating investigator, a blinded physician assessment of randomized photos using the HSRS, and patient questionnaires over a 12-month period. AEs were monitored by the investigator and via patient diaries.At weeks 4, 12, and 24, and month 12, all graders (ie, investigator, blinded physician assessor, and patients) reported improvement overall in hollowness. At baseline, temporal fossa hollowness was measured as moderate to severe. At week 4 to month 12, temporal fossa was graded at none or only mild hollowness. No touch-ups were necessary at week 4 on all subjects. All AEs were mild or moderate and resolved within 2 weeks.Our study demonstrates clinically significant efficacy and safety in the use of Restylane for temple augmentation and, thus, facial rejuventation.

Blinded study

Grading (engineering)

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