Analysis: PBoNT/A and ABoNT/A Show Fastest Onset in Glabellar Line Treatment

A newly published study reports the comparative effects of four botulinum toxin A (BoNT/A) formulations on glabellar strain, with observed differences in onset, longevity, and muscular strain patterns.

Researchers publishing in JAMA Dermatology conducted a double-blind, single-center study of 143 women (aged 30 to 65) who were randomly assigned into four treatment arms: 20 units of onabotulinum toxin A (OBoNT/A), 60 units of abobotulinum toxin A (ABoNT/A), 20 units of prabotulinum toxin A (PBoNT/A), and 20 units of incobotulinum toxin A (IBoNT/A). Researchers injected each formulation into the glabellar region; follow-up assessments using using dynamic 3-D photogrammetry were performed at days 3, 30, 90, and 180. 

According to the results, ABoNT/A and PBoNT/A showed the fastest onset, with results seen by day 3. PBoNT/A and IBoNT/A showed measurable efficacy relative to baseline at 180 days. PBoNT/A significantly outperformed OBoNT/A. FACE-Q module scores through day 90 showed improvement in all groups. 

"This randomized clinical trial found that ABoNT/A and PBoNT/A displayed the most rapid onset of effect," the authors wrote. "The peak effect is similar across all toxins. When measuring strain at approximately 6 months, some toxins remain significant relative to their own baseline or compared with other specific toxins."

Source: Lemdani M, et al. JAMA Dermatology. 2025. doi:10.1001/jamadermatol.2025.1335