Physical Address
304 North Cardinal St.
Dorchester Center, MA 02124
Topical botulinum toxin type A
Summary and key features
-
The favorable efficacy and safety profiles of injectable botulinum toxin type A (BoNTA) for facial aesthetic procedures and for medical indications are well established.
-
An unmet need exists for the development of systems or formulations for improved delivery of BoNTA in conditions not easily treated with injectable products.
-
The complex “bricks and mortar” anatomy of the skin prevents effective skin penetration and is a factor in the design and formulation of topically applied pharmacotherapies.
-
Cellular penetrating peptides are short peptide residues which can freely pass through cell membranes while transporting proteins, offering a mechanism for transdermal delivery of BoNTA.
-
Nano-emulsions provide a unique approach to overcoming challenges with drug solubility; they are characterized by greater stability and acceptable tolerability and can effectively penetrate the stratum corneum of the skin.
-
A topical gel is under development containing an albumin-free 150-kDa BoNTA bound to a proprietary cellular penetrating peptide enabling transcutaneous flux of BoNTA.
-
A nanoparticle delivery system is under development for the local, targeted, transdermal delivery of BoNTA.
Introduction
Injections of botulinum toxin type A (BoNTA) have become the most popular aesthetic procedure in the United States now widely used for on- and off-label use to treat glabellar lines, lateral canthal lines (LCLs), forehead lines, depressor anguli oris, and platysmal bands, to name a few. For most patients, the clinical benefits achieved with BoNTA treatment outweigh the risk of adverse effects. Most reported adverse effects are mild and transient and generally related to the pharmacology of the toxin (e.g., muscle weakness) or to the injection procedure itself (e.g., injection site pain, edema, and bruising).
The excellent efficacy and safety profiles of BoNTA in the treatment of diverse aesthetic and medical conditions suggest that it may also prove to be beneficial for other conditions with pathologies amenable to acetylcholinesterase inhibition. However, some medical and aesthetic conditions may require treatment of larger surface areas (i.e., axillary hyperhidrosis) or extremely sensitive areas (i.e., palmoplantar hyperhidrosis) requiring 50 to 60 needle sticks and thus do not lend to procedural ease. Additionally, needle phobia is not a trivial barrier, as fear of needles has been reported in 20%–30% of young adults; 16% of adults avoid receiving the influenza vaccination due to this fear. Hence, an unmet need exists for the development of improved systems or formulations for broader delivery of BoNTA while maintaining its efficacy. Herein we discuss challenges in the development of transdermal delivery systems and how these challenges are being addressed with specific focus on topical delivery of BoNTA.
Pearl 1:
Effective transdermal delivery of botulinum toxin type A may be an important advancement in the treatment of patients with conditions that could benefit from broad application of this compound and for those with needle phobia.
You're Reading a Preview
Become a Clinical Tree membership for Full access and enjoy Unlimited articles
If you are a member. Log in here
