Randomized, Double-blind, Active-controlled, Multicenter, Phase III Clinical Trial with Two Stages to Assess the Safety and Efficacy of Letibotulinum toxin A versus Onabotulinum toxin A for Subjects with Moderate to Severe Crow's Feet.

BACKGROUND Letibotulinum toxin A (LeBA) was approved by the Ministry of Food and Drug Safety (known as the Korea Food & Drug Administration) for cosmetic indications in 2012. However, the efficacy and safety of this newly introduced LeBA has not been investigated in crow's feet lines (CFL) treatment and standardization before its universal use. OBJECTIVE The aim of this multicenter, double-blind, randomized, parallel, active-controlled Phase III clinical trial with two stages (ClinicalTrials.gov identifier: NCT03408236) was to investigate the non-inferiority of LeBA versus the existing onabotulinum toxin A (OnBA) for the treatment of CFL. METHODS A total of 240 subjects were randomized to either the test (LeBA) or control (OnBA) group. At the baseline and at weeks 4 while maximum smiling (primary efficacy assessment), 8, 12, and 16, investigator's on-site evaluation, independent evaluator, evaluation by the subjects, subjects' satisfaction assessment, and safety assessment were performed. RESULTS At week 4, the response rate of primary efficacy assessment was 69.75% and 68.33% in the test (LeBA) and control (OnBA) groups, respectively, without a significant difference. Other minor secondary evaluation results showed significant differences suggesting that LeBA offered better improvement than OnBA, but the overall results did not show significant differences between the two groups. CONCLUSION This study showed that LeBA was as effective and safe as OnBA for the treatment of CFL at the same doses.