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CompletedNCT04622254ULTRA IIUpdated Aug 6, 2024Results posted

Safety and Efficacy Study of the Simultaneous Treatment of Upper Facial Lines (Horizontal Forehead Lines, Glabellar Frown Lines and Crows Feet) in Subjects With Moderate to Severe Upper Facial Lines

A Phase 3 interventional study of NT 201 and Placebo in Moderate to Severe Upper Facial Lines (Horizontal Forehead Lines, Glabellar Frown Lines, and Lateral Canthal Lines), sponsored by Merz North America, Inc.. Completed at 12 sites in Germany. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-08-06.

Sponsored by Merz North America, Inc. (part of Merz Pharma) · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
368
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this study is to investigate the safety and efficacy of NT 201 (active ingredient: Botulinum (neuro)toxin type A, free from complexing proteins) in the combined treatment of wrinkles in the upper face (Upper Facial Lines [UFL]): Horizontal Forehead Lines [HFL], Glabellar Frown Lines [GFL], and Lateral Canthal Lines [LCL]). It is a prospective, randomized, double-blind, placebo-controlled, multicenter study with a placebo-control main period (MP) followed by an open-label extension (OLEX) period.

02

Conditions studied

  • Moderate to Severe Upper Facial Lines (Horizontal Forehead Lines, Glabellar Frown Lines, and Lateral Canthal Lines)
03

In context

Lead sponsor

Merz North America, Inc. is the lead sponsor of 53 studies on the registry; 2 are open to participants now.

Of its 20 completed or terminated interventional studies of FDA-regulated products, 19 (95%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Outpatients (male or female) 18 years of age or older.
  • Horizontal forehead lines (HFL), glabellar frown lines (GFL), and symmetrical lateral canthal lines (LCL) of moderate to severe intensity at maximum contraction as assessed by the investigator and subject according to Merz Aesthetics Scales (MAS).

Exclusion criteria

Exclusion Criteria:

  • Previous treatment with botulinum neurotoxin (BoNT) of any serotype in the face within the last 12 months before injection.
  • Any facial cosmetic procedure within the last 12 months before baseline injection.
  • Previous treatment with any biodegradable filler in the face within the last 12 months before injection.
  • Any previous insertion of permanent material in the face (regardless of the time between previous treatment and this study).
  • Any medical condition that may put the subject at increased risk with exposure to NT201.
05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
368 participants (actual)

Study arms

  • Placebo comparator
    Main Period: Placebo (Group P)

    Subjects will receive placebo injection in all three UFL (GFL, HFL and LCL) on Day 1 of main period.

    Drug: Placebo

  • Experimental
    Main Period: NT 201 (Group U)

    Subjects will receive a total of 64 Units (U) of NT 201: 20 U of NT 201 injection both in the GFL area and in the HFL area, and 24 U of NT 201 injection in the LCL area (12 U per side) on Day 1 of main period.

    Drug: NT 201

  • Experimental
    Main Period: NT 201 and Placebo (Group L)

    Subjects will receive a total of 24 U NT 201: placebo injection both in the GFL and HFL area, and 24 U NT 201 injection in the LCL area (12 U per side) on Day 1 of main period.

    Drug: NT 201 · Drug: Placebo

  • Experimental
    OLEX: NT 201 (Main Period: Group P)

    Subjects will receive a total of 64 U of NT 201: 20 U of NT 201 injection both in the GFL and in the HFL area, and 24 U of NT 201 injection in the LCL area (12 U per side) on Day 1 (Visit 8) and Visit 13 of OLEX period.

    Drug: NT 201

  • Experimental
    OLEX: NT 201 (Main Period: Group U)

    Subjects will receive a total of 64 U of NT 201: 20 U of NT 201 injection both in the GFL and in the HFL area, and 24 U of NT 201 injection in the LCL area (12 U per side) on Day 1 (Visit 8) and Visit 13 of OLEX period.

    Drug: NT 201

  • Experimental
    OLEX: NT 201 (Main Period: Group L)

    Subjects will receive a total of 64 U of NT 201: 20 U of NT 201 injection both in the GFL and in the HFL area, and 24 U of NT 201 injection in the LCL area (12 U per side) on Day 1 (Visit 8) and Visit 13 of OLEX period.

    Drug: NT 201

Interventions

  • DrugNT 201

    Clostridium Botulinum neurotoxin Type A free from complexing proteins. Solution for injection prepared by reconstitution of powder with 0.9% Sodium Chloride (NaCl).

    Also known as: IncobotulinumtoxinA, Xeomin, Botulinum toxin type A (150 kiloDalton), free from complexing protein

  • DrugPlacebo

    Solution for injection prepared by reconstitution of powder with percent (%) Sodium Chloride (NaCl).

06

What researchers measure

Primary outcomes

  1. Main Period: Percentage of Glabellar Frown Line (GFL) Responders at Day 30

    The Merz aesthetics scales (MAS) are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. GFL-response was defined as a score of 0 (no) or 1 (mild) and at least two-grade improvement from baseline to Day 30 of main period on MAS for GFL at maximum contraction as assessed by both the investigator and the subject. The MAS for GFL ranged as 0 to 4 where 0 is "No glabellar lines", 1 is "Mild glabellar lines", 2 is "Moderate glabellar lines", 3 is "Severe glabellar lines" and 4 is "Very severe glabellar lines".

    Time frame: Day 30

  2. Main Period: Percentage of Horizontal Forehead Lines (HFL) Responders at Day 30

    The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. HFL-response was defined as a score of 0 (no) or 1 (mild) and at least two-grade improvement from baseline to Day 30 of main period on MAS for HFL at maximum contraction as assessed by both the investigator and the subject. The MAS for HFL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

    Time frame: Day 30

  3. Main Period: Percentage of Lateral Canthal Lines (LCL) Responders at Day 30

    The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. LCL-response was defined as a score of 0 (no) or 1 (mild) and at least two-grade improvement from baseline to Day 30 of main period on MAS for both left and right LCL at maximum contraction as assessed by both the investigator and the subject. The MAS for LCL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

    Time frame: Day 30

Secondary outcomes

  1. Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for GFL at Maximum Contraction as Assessed by the Investigator at Day 30

    The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. MAS for GFL ranged as 0 to 4, where 0 is "No glabellar lines", 1 is "Mild glabellar lines", 2 is "Moderate glabellar lines", 3 is "Severe glabellar lines" and 4 is "Very severe glabellar lines".

    Time frame: Day 30

  2. Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for HFL at Maximum Contraction as Assessed by the Investigator at Day 30

    The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for HFL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

    Time frame: Day 30

  3. Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator at Day 30

    The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for LCL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

    Time frame: Day 30

  4. Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for GFL at Maximum Contraction as Assessed by the Subject at Day 30

    The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for GFL ranged as 0 to 4, where 0 is "No glabellar lines", 1 is "Mild glabellar lines", 2 is "Moderate glabellar lines", 3 is "Severe glabellar lines" and 4 is "Very severe glabellar lines".

    Time frame: Day 30

  5. Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for HFL at Maximum Contraction as Assessed by the Subject at Day 30

    The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for HFL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

    Time frame: Day 30

  6. Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Subject at Day 30

    The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for LCL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

    Time frame: Day 30

  7. Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Subjects

    The GAIS is a 7-point Likert scale capturing the global aesthetic improvement ranging from +3 (very much improved); +2 (much improved); +1 (improved); 0 (no change); -1 (worse); -2 (much worse); -3 (very much worse), as assessed by the subject. GAIS as assessed by the subject at Day 30 was analyzed using an analysis of covariance (ANCOVA) model.

    Time frame: Day 30

  8. Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for GFL at Maximum Contraction as Assessed by the Investigator

    The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph- based outcome instruments designed specifically for assessment of each upper facial area. The MAS for GFL ranged as 0 to 4 where 0 is "No glabellar lines", 1 is "Mild glabellar lines", 2 is "Moderate glabellar lines", 3 is "Severe glabellar lines" and 4 is "Very severe glabellar lines".

    Time frame: Day 30

  9. Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for HFL at Maximum Contraction as Assessed by the Investigator

    The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for HFL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

    Time frame: Day 30

  10. Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator

    The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for LCL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

    Time frame: Day 30

  11. Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Investigator

    The GAIS is a 7-point Likert scale capturing the global aesthetic improvement ranging from +3 (very much improved); +2 (much improved); +1 (improved); 0 (no change); -1 (worse); -2 (much worse); -3 (very much worse), as assessed by the investigator. GAIS as assessed by the investigator at Day 30 was analyzed using an ANCOVA model.

    Time frame: Day 30

  12. Main Period: Number of Subjects With Related Treatment-Emergent Adverse Events (TEAEs)

    TEAEs during the Main Period are defined as adverse events (AEs) with onset or worsening on or after date and time of first dose of study treatment and before date and time of first administration of study treatment in the OLEX period or the final study visit, if subject was not treated in the OLEX period. An AE is considered to be related if a causal relationship between study treatment and the AE is at least reasonably possible.

    Time frame: Up to 22 weeks

  13. OLEX: Number of Subjects With Related TEAEs

    TEAEs of the OLEX period are defined as adverse events (AEs) with onset or worsening on or after date and time of first dose of study treatment in the OLEX period up to and including the final study visit. An AE is considered to be related if a causal relationship between study treatment and the AE is at least reasonably possible.

    Time frame: Up to 39 weeks

07

Results

Posted Aug 6, 2024

Participant flow

Subjects were recruited at 12 investigational sites in Germany.

Main Period (Up to 22 Weeks)
Participant flow — Main Period (Up to 22 Weeks)
MilestoneMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)OLEX: NT 201 (Main Period: Group P)OLEX: NT 201 (Main Period: Group U)OLEX: NT 201 (Main Period: Group L)
Started9418490000
Completed9118087000
Not completed343000
Withdrew: Adverse event010000
Withdrew: Withdrawal by subject212000
Withdrew: Protocol violation100000
Withdrew: Lost to follow-up021000
OLEX Period (Up to 39 Weeks)
Participant flow — OLEX Period (Up to 39 Weeks)
MilestoneMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)OLEX: NT 201 (Main Period: Group P)OLEX: NT 201 (Main Period: Group U)OLEX: NT 201 (Main Period: Group L)
Started0008917087
Completed0008115676
Not completed00081411
Withdrew: Adverse event000100
Withdrew: Lost to follow-up000302
Withdrew: Pregnancy000100
Withdrew: Other eligibility criteria for re-injection not met000100
Withdrew: No need for re-injection000193
Withdrew: Withdrawal by subject000154
Withdrew: Other000002

Outcome measures

PrimaryMain Period: Percentage of Glabellar Frown Line (GFL) Responders at Day 30

The Merz aesthetics scales (MAS) are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. GFL-response was defined as a score of 0 (no) or 1 (mild) and at least two-grade improvement from baseline to Day 30 of main period on MAS for GFL at maximum contraction as assessed by both the investigator and the subject. The MAS for GFL ranged as 0 to 4 where 0 is "No glabellar lines", 1 is "Mild glabellar lines", 2 is "Moderate glabellar lines", 3 is "Severe glabellar lines" and 4 is "Very severe glabellar lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Glabellar Frown Line (GFL) Responders at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Glabellar Frown Line (GFL) Responders at Day 30049.5
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
PrimaryMain Period: Percentage of Horizontal Forehead Lines (HFL) Responders at Day 30

The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. HFL-response was defined as a score of 0 (no) or 1 (mild) and at least two-grade improvement from baseline to Day 30 of main period on MAS for HFL at maximum contraction as assessed by both the investigator and the subject. The MAS for HFL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Horizontal Forehead Lines (HFL) Responders at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Horizontal Forehead Lines (HFL) Responders at Day 30057.7
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
PrimaryMain Period: Percentage of Lateral Canthal Lines (LCL) Responders at Day 30

The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. LCL-response was defined as a score of 0 (no) or 1 (mild) and at least two-grade improvement from baseline to Day 30 of main period on MAS for both left and right LCL at maximum contraction as assessed by both the investigator and the subject. The MAS for LCL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Lateral Canthal Lines (LCL) Responders at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Lateral Canthal Lines (LCL) Responders at Day 30032.4
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for GFL at Maximum Contraction as Assessed by the Investigator at Day 30

The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. MAS for GFL ranged as 0 to 4, where 0 is "No glabellar lines", 1 is "Mild glabellar lines", 2 is "Moderate glabellar lines", 3 is "Severe glabellar lines" and 4 is "Very severe glabellar lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for GFL at Maximum Contraction as Assessed by the Investigator at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for GFL at Maximum Contraction as Assessed by the Investigator at Day 300.086.8
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for HFL at Maximum Contraction as Assessed by the Investigator at Day 30

The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for HFL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for HFL at Maximum Contraction as Assessed by the Investigator at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for HFL at Maximum Contraction as Assessed by the Investigator at Day 301.186.3
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator at Day 30

The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for LCL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator at Day 302.175.8
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for GFL at Maximum Contraction as Assessed by the Subject at Day 30

The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for GFL ranged as 0 to 4, where 0 is "No glabellar lines", 1 is "Mild glabellar lines", 2 is "Moderate glabellar lines", 3 is "Severe glabellar lines" and 4 is "Very severe glabellar lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for GFL at Maximum Contraction as Assessed by the Subject at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for GFL at Maximum Contraction as Assessed by the Subject at Day 301.173.6
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for HFL at Maximum Contraction as Assessed by the Subject at Day 30

The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for HFL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for HFL at Maximum Contraction as Assessed by the Subject at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for HFL at Maximum Contraction as Assessed by the Subject at Day 302.179.1
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Subject at Day 30

The MAS are 5-point scales used to identify responders in clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for LCL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Subject at Day 30
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Percentage of Subjects With a Score of 0 (no) or 1 (Mild) on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Subject at Day 303.265.4
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Subjects

The GAIS is a 7-point Likert scale capturing the global aesthetic improvement ranging from +3 (very much improved); +2 (much improved); +1 (improved); 0 (no change); -1 (worse); -2 (much worse); -3 (very much worse), as assessed by the subject. GAIS as assessed by the subject at Day 30 was analyzed using an analysis of covariance (ANCOVA) model.

Time frame:
Day 30
Reported as:
Least squares mean · score on a scale
Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Subjects
score on a scaleMain Period: Placebo (Group P)Main Period: NT 201 (Group U)
Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Subjects0.02 (-0.11 to 0.15)2.00 (1.90 to 2.09)
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · ANCOVA · p = <0.0001
SecondaryMain Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for GFL at Maximum Contraction as Assessed by the Investigator

The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph- based outcome instruments designed specifically for assessment of each upper facial area. The MAS for GFL ranged as 0 to 4 where 0 is "No glabellar lines", 1 is "Mild glabellar lines", 2 is "Moderate glabellar lines", 3 is "Severe glabellar lines" and 4 is "Very severe glabellar lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for GFL at Maximum Contraction as Assessed by the Investigator
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for GFL at Maximum Contraction as Assessed by the Investigator5.596.74.5
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for HFL at Maximum Contraction as Assessed by the Investigator

The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for HFL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for HFL at Maximum Contraction as Assessed by the Investigator
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for HFL at Maximum Contraction as Assessed by the Investigator3.396.13.4
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator

The MAS are 5-point scales used to identify responders in a clinical context. They are validated photograph-based outcome instruments designed specifically for assessment of each upper facial area. The MAS for LCL ranged as 0 to 4 where 0 is "No lines", 1 is "Mild lines", 2 is "Moderate lines", 3 is "Severe lines" and 4 is "Very severe lines".

Time frame:
Day 30
Reported as:
Number · percentage of subjects
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator
percentage of subjectsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 of Main Period on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator8.891.768.2
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · Mantel Haenszel · p = <0.0001
  • Main Period: Placebo (Group P) vs Main Period: NT 201 and Placebo (Group L) · Mantel Haenszel · p = <0.0001
SecondaryMain Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Investigator

The GAIS is a 7-point Likert scale capturing the global aesthetic improvement ranging from +3 (very much improved); +2 (much improved); +1 (improved); 0 (no change); -1 (worse); -2 (much worse); -3 (very much worse), as assessed by the investigator. GAIS as assessed by the investigator at Day 30 was analyzed using an ANCOVA model.

Time frame:
Day 30
Reported as:
Least squares mean · score on a scale
Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Investigator
score on a scaleMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)
Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Investigator0.03 (-0.09 to 0.14)2.23 (2.14 to 2.31)0.68 (0.56 to 0.80)
Statistical analysis
  • Main Period: Placebo (Group P) vs Main Period: NT 201 (Group U) · ANCOVA · p = <0.0001
  • Main Period: Placebo (Group P) vs Main Period: NT 201 and Placebo (Group L) · ANCOVA · p = <0.0001
SecondaryMain Period: Number of Subjects With Related Treatment-Emergent Adverse Events (TEAEs)

TEAEs during the Main Period are defined as adverse events (AEs) with onset or worsening on or after date and time of first dose of study treatment and before date and time of first administration of study treatment in the OLEX period or the final study visit, if subject was not treated in the OLEX period. An AE is considered to be related if a causal relationship between study treatment and the AE is at least reasonably possible.

Time frame:
Up to 22 weeks
Reported as:
Count of participants · Participants
Main Period: Number of Subjects With Related Treatment-Emergent Adverse Events (TEAEs)
ParticipantsMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 (Group L)
Main Period: Number of Subjects With Related Treatment-Emergent Adverse Events (TEAEs)123510
SecondaryOLEX: Number of Subjects With Related TEAEs

TEAEs of the OLEX period are defined as adverse events (AEs) with onset or worsening on or after date and time of first dose of study treatment in the OLEX period up to and including the final study visit. An AE is considered to be related if a causal relationship between study treatment and the AE is at least reasonably possible.

Time frame:
Up to 39 weeks
Reported as:
Count of participants · Participants
OLEX: Number of Subjects With Related TEAEs
ParticipantsOLEX: NT 201 (Main Period: Group P)OLEX: NT 201 (Main Period: Group U)OLEX: NT 201 (Main Period: Group L)
OLEX: Number of Subjects With Related TEAEs183212

Adverse events

Collected over Main Period: Up to 22 weeks; OLEX Period: Up to 39 weeks. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Main Period: Placebo (Group P)0/94 (0%)4/94 (4.3%)23/94 (24.5%)
Main Period: NT 201 (Group U)0/184 (0%)1/184 (0.5%)43/184 (23.4%)
Main Period: NT 201 and Placebo (Group L)0/90 (0%)2/90 (2.2%)23/90 (25.6%)
OLEX: NT 201 (Main Period: Group P)0/89 (0%)2/89 (2.2%)39/89 (43.8%)
OLEX: NT 201 (Main Period: Group U)0/170 (0%)6/170 (3.5%)74/170 (43.5%)
OLEX: NT 201 (Main Period: Group L)0/87 (0%)3/87 (3.4%)29/87 (33.3%)
Most frequent serious events
Showing 10 of 20
Most frequent serious events
EventMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)OLEX: NT 201 (Main Period: Group P)OLEX: NT 201 (Main Period: Group U)OLEX: NT 201 (Main Period: Group L)
Drug hypersensitivityImmune system disorders0/940/1840/900/890/1701/87
Haemoglobin decreasedInvestigations0/940/1840/900/890/1701/87
Back painMusculoskeletal and connective tissue disorders0/940/1840/900/890/1701/87
OsteoarthritisMusculoskeletal and connective tissue disorders0/940/1840/900/890/1701/87
VertigoEar and labyrinth disorders0/940/1840/901/890/1700/87
GoitreEndocrine disorders0/940/1840/901/891/1700/87
Inguinal herniaGastrointestinal disorders1/940/1840/901/890/1700/87
SciaticaNervous system disorders0/940/1841/900/890/1700/87
Nasal septum deviationRespiratory, thoracic and mediastinal disorders0/940/1841/900/890/1700/87
Abdominal painGastrointestinal disorders1/940/1840/900/891/1700/87
Most frequent other events
Most frequent other events
EventMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)OLEX: NT 201 (Main Period: Group P)OLEX: NT 201 (Main Period: Group U)OLEX: NT 201 (Main Period: Group L)
COVID-19Infections and infestations4/942/1840/9013/8933/17012/87
NasopharyngitisInfections and infestations4/943/1843/909/8922/17011/87
Injection site haematomaGeneral disorders8/9415/1849/9011/8922/1709/87
HeadacheNervous system disorders8/9418/1847/909/899/1702/87
Immunisation reactionImmune system disorders2/9410/1849/904/898/1708/87

Baseline characteristics

The full analysis set (FAS) included all randomized subjects.

Age, Continuous
Age, Continuous(years)Main Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)Total
Mean44.8 ± 9.1546.0 ± 9.9245.9 ± 9.8845.7 ± 9.71
Sex: Female, Male
Sex: Female, Male(Participants)Main Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)Total
Female8414772303
Male10371865
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Main Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)Total
Hispanic or Latino1225
Not Hispanic or Latino9318288363
Unknown or Not Reported0000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Main Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group L)Total
American Indian or Alaska Native0101
Asian0011
Native Hawaiian or Other Pacific Islander0000
Black or African American0101
White9418289365
More than one race0000
Unknown or Not Reported0000
08

Study locations

12 sites
  • Merz Investigational Site
    Bad Soden, 65182, Germany
  • Merz Investigational Site
    Berlin, 10707, Germany
  • Merz Investigational Site
    Bochum, 44793, Germany
  • Merz Investigational Site
    Drensteinfurt, 48317, Germany
  • Merz Investigational Site
    Düsseldorf, 40212, Germany
  • Merz Investigational Site
    Hamburg, 20146, Germany
  • Merz Investigational Site
    Hamburg, 22609, Germany
  • Merz Investigational Site
    Mannheim, 68161, Germany
  • Merz Investigational Site
    München, 80539, Germany
  • Merz Investigational Site
    München, 80636, Germany
  • Merz Investigational Site
    Potsdam, 14467, Germany
  • Merz Investigational Site
    Wuppertal, 42287, Germany
09

References and documents

Publications

  • Pavicic T, Burgess C, Fabi S, Nestor MS, Bee EK, Imhof M, Dersch H, Sudimac V. Aesthetic Improvements Over Time: Long-Term Efficacy and Additional Outcomes of IncobotulinumtoxinA in the Simultaneous Treatment of Upper Facial Lines. J Cosmet Dermatol. 2025 Sep;24(9):e70460. doi: 10.1111/jocd.70460. PubMed 40968493 ↗
  • Joseph J, Sudimac V, Mersmann S, Kerscher M. IncobotulinumtoxinA in the Treatment of Upper Facial Lines: Results From Two Randomized, Double-Blind, Placebo-Controlled, Phase III Studies. Aesthet Surg J. 2025 Feb 18;45(3):293-304. doi: 10.1093/asj/sjae222. PubMed 39475143 ↗

Study documents

  • Study protocol · Jun 24, 2021
  • Statistical analysis plan · Sep 16, 2022

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 6, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT04622254
Responsible party
Sponsor
First posted
Nov 9, 2020
Start date
Nov 12, 2020
Primary completion
Jun 16, 2021
Completion
Jul 8, 2022
Results posted
Aug 6, 2024
Last update
Aug 6, 2024

Study contacts

Merz Medical Expert
study director · Merz North America, Inc.

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: incobotulinumtoxinA

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