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Phase 3 N=355 Randomized Double-blind Treatment

Botulinum Toxin Treatment of Glabellar Lines: Efficacy and Safety Study III (BLESSIII)

Glabellar Frown Lines

Enrolled (actual)
355
Serious AEs
0.9%
Results posted
Jun 2025
Primary outcome: Primary: Facial Wrinkle Scale (FWS) Score of 0 or 1 and an Improvement of ≥ 2 Points in FWS Score (at Maximum Frown) at Week 4 Visit Relative to Baseline, Based on Both the Investigators´ and the Subjects´ In-clinic Assessments. — 172; 0 Participants — p=<0.001

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Botulinum Toxin A (Drug); Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Croma-Pharma GmbH
Primary completion
Dec 2019

Outcome Measures

OutcomeResultp-value
PRIMARY
Facial Wrinkle Scale (FWS) Score of 0 or 1 and an Improvement of ≥ 2 Points in FWS Score (at Maximum Frown) at Week 4 Visit Relative to Baseline, Based on Both the Investigators´ and the Subjects´ In-clinic Assessments.
172; 0 <0.001 sig
SECONDARY
Extent of Change in Psychological Impact (Emotional and Social Functioning and Concerns Relating to Glabellar Lines)
-42.27; 0.50; -33.14; -2.23; -38.35; -0.67 <0.001 sig
SECONDARY
Percentage of Responders at Maximum Frown at Week 12
56; 1
SECONDARY
Percentage of Responders at Week 16
27; 1
SECONDARY
Percentage of Responders at Week 20
5; 0
SECONDARY
The Percentage of Subjects With a ≥ 1 Point Reduction in Facial Wrinkle Scale (FWS) Score at Rest at Week 4 Based Separately on the Investigators´ and the Subjects´ In-clinic Assessments
163; 8; 214; 11
SECONDARY
Responder Rate at Weeks 1, 2 and 8
150; 0; 189; 0; 129; 0
SECONDARY
The Percentage of Subjects With ≥ 2-point and ≥ 1 Reduction in Facial Wrinkle Scale (FWS) Score (at Maximum Frown)
150; 0; 144; 0; 11; 1
SECONDARY
Time to Onset of Effect in the BoNT/A-DP and Placebo Groups in the First Treatment Cycle
8; NA
SECONDARY
Satisfaction With Treatment, During Each Treatment Cycle, as Assessed by the Validated FACE-Q Satisfaction With Outcome Scale.
16; 78; 13; 3; 46; 4
SECONDARY
The Percentage of Subjects With a ≥ 1 Point Reduction in Facial Wrinkle Scale (FWS) Score at Rest Based on the Independent Rater's Assessment of Photos.
106; 9; 100; 13; 37; 8
SECONDARY
Facial Wrinkle Scale (FWS) Score of 0 or 1 and an Improvement of ≥ 2 Points in FWS Score (at Maximum Frown) at 4 Weeks After Re-treatment Relative to the Rating at the Preceding End-of-Cycle Visit.
153; 119; 43
SECONDARY
The Percentage of Subjects With ≥ 1-point Reduction in Facial Wrinkle Scale (FWS) Score (at Maximum Frown) During the First Treatment Cycle at Week 1, 2, 4, 8, 12, 16 and 20 Relative to Baseline
220; 2; 234; 0; 236; 0
SECONDARY
The Percentage of Subjects With ≥ 1-point Reduction in Facial Wrinkle Scale (FWS) Score (at Maximum Frown) During Each Re-treatment Cycle at Week 4 Relative to Re-treatment-baseline.
267; 210; 104
SECONDARY
Number of Participants With Treatment-emergent Adverse Events (TEAEs), Serious AEs (SAEs) and AEs of Special Interest (AESIs)
48; 14; 80; 4; 0; 8
SECONDARY
Number of Participants With Neutralizing Anti-Drug Antibodies
23; 4; 0; 0; 0; 0
SECONDARY
Change From Baseline of Basophils, Eosinophils, Leukocytes, Lymphocytes, Monocytes, Neutrophils, Platelets
0.004; 0.012; 0.006; 0.007; -0.029; 0.227
SECONDARY
Change From Baseline of Alanine Aminotransferase, Alkaline Phosphatase , Aspartate Aminotransferase, Gamma Glutamyl Transpeptidase
-0.1; 1.9; -0.8; -0.5; 0.2; 0.1
SECONDARY
Change From Baseline of Cholesterol, Glucose, Potassium, Sodium, Urea Nitrogen
-0.119; -0.049; 0.317; 0.290; -0.06; -0.09
SECONDARY
Change From to Baseline of Bilirubin, Creatinin
0.05; -0.14; 0.52; -0.30; -0.12; -0.49
SECONDARY
Change From Baseline of Erythrocytes
-0.002; -0.038; 0.032; 0.063; 0.041
SECONDARY
Change From Baseline of Erythrocytes MCV
-0.78; -0.79; -0.38; 0.53; 2.18
SECONDARY
Change From Baseline of Erythrocyte MCHC, Hemoglobin
0.32; 0.33; 0.02; -0.09; 0.16; 0.12
SECONDARY
Change From Baseline of Lymphocytes/Leukocytes, Monocytes/Leukocytes, Neutrophils/Leukocytes, Basophiles/Leukocytes, Eosinophils/Leukocytes
0.05; 0.14; 0.14; 0.05; -0.26; -1.13
SECONDARY
Change From Baseline of Systolic and Diastolic Blood Pressure
-0.7; -0.2; -1.0; 1.3; -0.9; 0.0
SECONDARY
Change From Baseline of Pulse Rate
-1.7; 0.1; 1.2; 2.2; 0.7
SECONDARY
Number of Participants With Normal and Abnormal Electrocardiogram
223; 5; 71; 3; 13; 22

Summary

The aim of this study is to assess the efficacy and safety of BoNT/A-DP in the treatment of glabellar lines in comparison with placebo, including efficacy after repeat treatments and long term safety.

Eligibility Criteria

Inclusion Criteria

  • Ages ≥ 18 years or older at time of screening (upper limit 75 years, inclusive).
  • Has moderate to severe glabellar frown lines at maximum frown (severity score of 2 or 3 on FWS) as determined by in-clinic assessments by both the investigator and the subject (where: 0 =´none´, 1= ´mild´, 2= ´moderate´, 3= ´severe´).

Subject had a stable medical condition with no uncontrolled systemic disease.

  • Female subjects of childbearing potential had to test negative for pregnancy and agree to use effective birth control during the course of the study.
  • Subjects who wear glasses had to be able to adequately self-assess the severity of their glabellar lines (according to the FWS), without glasses obstructing the forehead area.
  • Moderate to severe glabellar lines indicating an important psychological impact on the subject as indicated by scores > 0 on either the Emotional or the Social Functioning subscale of the Modified Skindex-16 GL-QoL scale.

Exclusion Criteria

  • Previous treatment with any serotype of botulinum toxin for any indication within the 12 months prior to screening, or any planned treatment with botulinum toxin of any serotype for any reason during the study (other than the investigational treatment).
  • Known hypersensitivity to the study drug or its excipients.
  • Any medical condition that may place the subject at increased risk due to exposure to botulinum toxin, including diagnosed myasthenia gravis, Eaton-Lambert syndrome, amyotrophic lateral sclerosis, profound atrophy or weakness in the target muscles, or any other condition (at the investigator´s discretion) that might interfere with neuromuscular function or contraindicate botulinum toxin therapy.
  • Facial laser or light treatment, microdermabrasion, superficial peels or retinoid therapy within the 3 months prior to screening or planned during the study.
  • Apart from the procedures specified above, previous treatment with any facial aesthetic procedure in the glabellar area (including chemical peeling, injection with biodegradable fillers) within 12 months prior to screening or planned during the study.
  • Previous treatment with any serotype of botulinum toxin for any indication within the 12 months prior to screening, or any planned treatment with botulinum toxin of any serotype for any reason during the trail (other than the investigational treatment).
  • Previous insertion of permanent material in the glabellar area or planned during the study.
  • Any surgery, or history of surgery, in the glabellar area including surgical removal of the corrugator, procerus or depressor supercilii muscles or a combination of these or scars in the glabellar area or such surgery planned during the study.
  • Active skin disease/infection or irritation at the treatment area.
  • Inability to substantially lessen glabellar frown lines even by physically spreading them apart.
  • Use of a muscle relaxant within 2 weeks prior to screening, or planned during the study.2
  • Marked facial asymmetry or ptosis of eyelid and/or eyebrow, or current facial palsy or neuromuscular junction disorders as judged by the investigator.
  • Pregnant, breastfeeding or planning to become pregnant during the study.
  • Use of prohibited medication including anticholinergic drugs, or drugs that could interfere with neuromuscular function, including aminoglycoside antibiotics and curare-like compounds within 2 weeks prior to screening or planned during the study.2
  • Planned surgery with general anesthetic (use of local anesthetic outside the glabellar area was permitted).
  • Participation in another clinical study within 1 month of screening and throughout the study.
  • Previous participation in another botulinum toxin aesthetic study which involved the treatment of glabellar lines in combination with canthal lines and/or forehead lines, within the previous 18 months.
  • Chronic drug or alcohol abuse (as per investigator discretion).

Eligibility Criteria for Retreatment

The following criteri

View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03985982). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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