CODE AFA Practitioner Articles
Topical Botulinum Toxin
The concept of a topical application to eliminate wrinkles is not new, however, until recently, the theory has not been conclusively accomplished. Now researchers of Reverance Therapeutics, Inc. believe they are very close. They produced impressive data of effective treatment of crow’s feet with a topical, non-injectable form of botulinum toxin from a phase II clinical trial involving 75 participants at 4 different sites.
The developers claim that the topical allows large macromolecules to cross the skin and other barrier membranes enabling local, targeted delivery. Delivered through the firm’s proprietary TransMTS™ (Macromolecule Transport Technology), the neurotoxin is based on a single, straight-chain, peptide that allows skin to be a gateway for drug delivery, rather than a barrier.
“Adding a peptide as a separate component within the [toxin] formulation allows the toxin to cross the skin,” explains Jacob Waugh, M.D., co-founder & chief scientific officer, Revance. “The peptide forms an ionic bond with the toxin and the peptide also has a Protein Transduction Domain (PTD), which is responsible for transcutaneous flux. It is essentially a quite broad and powerful transduction.”
The key to TransMTS technology, say its developers, is a protein carrier featuring protein transduction domains that hold on to the cell membrane and allow larger molecules to pass through it undisturbed. The transport technology is also currently being studied for early applications of new cardiovascular disease drugs.
A phase III trial is underway to establish the neurotoxin adjunct’s effectiveness and advantages when treating crow’s feet, an area greatly sensitive to injections. A topical toxin may be a relief to most patients who will be able to avoid injection discomfort and side effects associated with botulinum toxin injections that currently include: redness, puffiness, light bruising and in some cases, systemic adverse reactions.
A topical toxin could help many of the 11 million+ consumers interested in anti-wrinkle treatments, but who do not like injections.
