Phase 3
N=355
Botulinum Toxin Treatment of Glabellar Lines: Efficacy and Safety Study III (BLESSIII)
Glabellar Frown Lines
Bottom Line
View on ClinicalTrials.gov: NCT03985982 ↗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
| Outcome | Result | p-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
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.