Skin Smoothness of the Cheeks
Conditions
Brief summary
This is a pivotal study to collect safety and effectiveness data on JUVÉDERM VOLITE™ XC for improvement in skin smoothness of the cheeks in order to support FDA product approval.
Interventions
Intradermal, needle in multiple microdepot injections across both cheeks.
Sponsors
Study design
Eligibility
Inclusion criteria
* Ability to follow study instructions and likely to complete all required visits; * Written informed consent and data privacy consent have been obtained
Exclusion criteria
* Has undergone tissue augmentation with dermal fillers including hyaluronic acid (HA), calcium hydroxylapatite, autologous fat, mesotherapy, or other cosmetic procedures (eg, face-lift, laser, photomodulation, intense pulsed light, radiofrequency, dermabrasion, chemical peel, or other ablative procedures) in the fact within 12 months before screening or is planning to undergo any such treatment during the study; * Has received any crosslinked HA filler in any anatomic area within 12 months of screening; * Has undergone treatment with botulinum toxin in the cheek area (including crow's feet) within 6 months of screening or is planning to undergo such treatment during the study; * Has ever received semi-permanent fillers or permanent facial implants (eg, poly-L-lactic acid, polymethylmethacrylate, silicone, expanded polytetrafuoroethylene) anywhere in the face or is planning to be implanted with any of these products at any time during the study; * Has facial tattoos, piercings, pigmentation, hair (ie, beard, mustache), or past trauma that would interfere with the visualization of the face for the effectiveness assessments; * Has undergone a dental procedure within 6 weeks before treatment or plans to undergo a dental procedure (other than prophylasix or dental fillings) during the course of the study; * Has tendency to develop hypertrophic scarring; * Has a history of allergy to lidocaine, HA products, and/or to gram-positive bacterial proteins as HA is produced by Streptococcus-type bacteria, or is planning to undergo desensitization therapy during the term of the study; * Has a history of anaphylactic shock; * Has current cutaneous inflammatory or infectious processes (eg, acne, herpes), abscess, an unhealed wound, or a cancerous or precancerous lesion on the face (injection may be delayed to allow subjects with a history of recurrent oral herpes to take prophylactic antiviral/herpes medication for 2 days); * Is on an ongoing regimen of anticoagulation therapy (eg, warfarin) or is known to have a coagulation disorder; * Is on an ongoing regimen of medications (eg, aspirin, ibuprofen) or other substances (eg, herbal supplements with garlic, ginkgo biloba, or ginseng) known to increase coagulation time within 10 days of undergoing study device injection (study device injection may be delayed as necessary to accommodate this 10-day washout period); * Has active autoimmune disease; * Has received any investigational product within 30 days before enrollment or is planning to participate in another investigation during the course of this study; - Has begun using any over-the-counter or prescription, oral or topical, anti-wrinkle products on the face within 30 days before enrollment or is planning to begin using such products during the study (subjects who have been on a regimen of such products for at least 30 days are eligible for the study if they intend to continue their regimen throughout the study); * Females who are pregnant, nursing, or planning a pregnancy during the study; * Is an employee (or a relative of an employee) of the principal investigator (PI)/evaluating investigator (EI)/treating investigator(TI)/site, Allergan, or representative of Allergan' * Has a condition or is in a situation which, in the TI's opinion, may put the subject at significant risk, may confound the study results, or may interfere significantly with the subject's participation in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With at Least 1-point Improvement (Decrease) From Baseline on the Allergan Cheek Smoothness Scale (ACSS) on Both Cheeks at Month 1 | Baseline to Month 1 | The ACSS is a validated 5-point ordinal scale developed by Allergan to grade the severity of skin smoothness on the cheeks. The score ranges from 0 (smooth visual skin texture) to 4 (extremely coarse visual skin texture, crosshatched deep creases, extreme elastosis. Responders are participants with at least 1-point improvement (decrease) from baseline on the ACSS on both cheeks based on evaluating investigator (EI) assessment. Baseline is the last non-missing EI assessment on or before the latter of randomization date or first study treatment date in the control period. The multiple imputation method for the missing data imputation was used for analysis. |
| Number of Participants Who Experience One or More Treatment Emergent Adverse Event (TEAE) | From first dose of study treatment until 30 days following last dose of study treatment (up to approximately 12 months) | An adverse event (AE) is defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical device which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study device. An AE was considered a treatment emergent adverse event (TEAE) if the AE began or worsened (increased in severity or became serious) after first administration of VOLITE for the treatment group and after the date of randomization for the control group. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change From Baseline in Face-Q Satisfaction With Skin Questionnaire at Month 1 | Baseline and Month 1 | The participant assessed satisfaction using the 12 items on the FACE-Q: Satisfaction with Skin questionnaire measured on a 4-point scale where 1=very dissatisfied, 2=somewhat dissatisfied, 3=somewhat satisfied, 4=very satisfied. The responses to the 12 items were summed and converted to a scale score that ranges from 0 (worst) to 100 (best). Higher score indicates more satisfaction. A positive change from baseline indicates improvement. |
| Percentage of Participants With at Least 1-Point Improvement (Decreased) From Baseline on Both Cheeks in the Allergan Fine Lines Scale (AFLS) Response at Month 1 | Baseline to Month 1 | The AFLS is a validated 5-point ordinal scale developed by Allergan to grade the severity of fine lines on the cheeks. The score ranges from 0 (no fine lines) to 4 (diffuse superficial lines, crosshatching). Responders are participants with at least 1-point improvement (decrease) from baseline on the AFLS on both cheeks based on observed data of EI assessment. Baseline is the last non-missing EI assessment on or before the latter of randomization date or first study treatment date in the control period. |
Countries
Puerto Rico, United States
Participant flow
Pre-assignment details
A total of 209 participants were randomized out of which 202 participants were included in (modified intent-to-treat) mITT population.
Participants by arm
| Arm | Count |
|---|---|
| Control Group: No Treatment Then Optional JUVÉDERM® VOLITE™ Participants received no treatment for up to 30 days and then received an optional JUVÉDERM® VOLITE™ XC injectable gel initial treatment intradermally up to 4 mLs and an optional touch-up treatment up to 2 mL 30 days later, if applicable. | 71 |
| JUVÉDERM VOLITE™ XC Participants received an initial treatment of JUVÉDERM® VOLITE™ XC injectable gel, intradermally up to 4 mL on Day 1 for both cheeks followed by an optional touch-up treatment up to 2 mL on Day 30, if applicable. Participants were eligible to receive repeat treatment up to 4mL at Month 6, if applicable. | 131 |
| Total | 202 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 0 | 1 |
| Overall Study | Due to COVID | 1 | 3 |
| Overall Study | Lost to Follow-up | 9 | 10 |
| Overall Study | Protocol Deviation | 0 | 1 |
| Overall Study | Randomized but not Treated | 0 | 1 |
| Overall Study | Withdrawal by Subject | 2 | 8 |
Baseline characteristics
| Characteristic | JUVÉDERM VOLITE™ XC | Total | Control Group: No Treatment Then Optional JUVÉDERM® VOLITE™ |
|---|---|---|---|
| Age, Continuous | 58.0 years STANDARD_DEVIATION 8.24 | 57.1 years STANDARD_DEVIATION 8.73 | 55.5 years STANDARD_DEVIATION 9.42 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 35 Participants | 56 Participants | 21 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 96 Participants | 146 Participants | 50 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Black or African American | 13 Participants | 21 Participants | 8 Participants |
| Race (NIH/OMB) More than one race | 1 Participants | 2 Participants | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 115 Participants | 177 Participants | 62 Participants |
| Sex: Female, Male Female | 109 Participants | 174 Participants | 65 Participants |
| Sex: Female, Male Male | 22 Participants | 28 Participants | 6 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 74 | 0 / 135 | 0 / 64 | 0 / 79 |
| other Total, other adverse events | 0 / 74 | 2 / 135 | 4 / 64 | 0 / 79 |
| serious Total, serious adverse events | 0 / 74 | 6 / 135 | 3 / 64 | 3 / 79 |
Outcome results
Number of Participants Who Experience One or More Treatment Emergent Adverse Event (TEAE)
An adverse event (AE) is defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical device which does not necessarily have a causal relationship with this treatment. The investigator assesses the relationship of each event to the use of study device. An AE was considered a treatment emergent adverse event (TEAE) if the AE began or worsened (increased in severity or became serious) after first administration of VOLITE for the treatment group and after the date of randomization for the control group.
Time frame: From first dose of study treatment until 30 days following last dose of study treatment (up to approximately 12 months)
Population: Safety Population included all participants who are randomized and received study intervention (VOLITE or no treatment). A participant was randomized to the JUVÉDERM VOLITE™ XC arm, but not treated in the study. Therefore, this participant was included in the treatment group for the mITT population and in the control group for the safety population
| Arm | Measure | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|
| Control Group: No Treatment Then Optional JUVÉDERM® VOLITE™ | Number of Participants Who Experience One or More Treatment Emergent Adverse Event (TEAE) | 5 Participants |
| JUVÉDERM VOLITE™ XC | Number of Participants Who Experience One or More Treatment Emergent Adverse Event (TEAE) | 14 Participants |
| Treated Period: VOLITE Post-Control Group | Number of Participants Who Experience One or More Treatment Emergent Adverse Event (TEAE) | 14 Participants |
| Repeat Treatment Period: JUVÉDERM® VOLITE™ XC | Number of Participants Who Experience One or More Treatment Emergent Adverse Event (TEAE) | 5 Participants |
Percentage of Participants With at Least 1-point Improvement (Decrease) From Baseline on the Allergan Cheek Smoothness Scale (ACSS) on Both Cheeks at Month 1
The ACSS is a validated 5-point ordinal scale developed by Allergan to grade the severity of skin smoothness on the cheeks. The score ranges from 0 (smooth visual skin texture) to 4 (extremely coarse visual skin texture, crosshatched deep creases, extreme elastosis. Responders are participants with at least 1-point improvement (decrease) from baseline on the ACSS on both cheeks based on evaluating investigator (EI) assessment. Baseline is the last non-missing EI assessment on or before the latter of randomization date or first study treatment date in the control period. The multiple imputation method for the missing data imputation was used for analysis.
Time frame: Baseline to Month 1
Population: mITT Population included all randomized participants who have baseline assessment on the ACSS scale for both cheeks, and are not in the Fitzpatrick V/VI safety cohort. Missing data in ACSS at Month 1 was imputed using the Multiple Imputation method.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Control Group: No Treatment Then Optional JUVÉDERM® VOLITE™ | Percentage of Participants With at Least 1-point Improvement (Decrease) From Baseline on the Allergan Cheek Smoothness Scale (ACSS) on Both Cheeks at Month 1 | 4.5 percentage of participants |
| JUVÉDERM VOLITE™ XC | Percentage of Participants With at Least 1-point Improvement (Decrease) From Baseline on the Allergan Cheek Smoothness Scale (ACSS) on Both Cheeks at Month 1 | 57.9 percentage of participants |
Change From Baseline in Face-Q Satisfaction With Skin Questionnaire at Month 1
The participant assessed satisfaction using the 12 items on the FACE-Q: Satisfaction with Skin questionnaire measured on a 4-point scale where 1=very dissatisfied, 2=somewhat dissatisfied, 3=somewhat satisfied, 4=very satisfied. The responses to the 12 items were summed and converted to a scale score that ranges from 0 (worst) to 100 (best). Higher score indicates more satisfaction. A positive change from baseline indicates improvement.
Time frame: Baseline and Month 1
Population: mITT Population included all randomized participants who had baseline assessment on the ACSS scale for both cheeks, and are not in the Fitzpatrick V/VI safety cohort. Number analyzed are the number of participants with data available for analysis at the given timepoint.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Control Group: No Treatment Then Optional JUVÉDERM® VOLITE™ | Change From Baseline in Face-Q Satisfaction With Skin Questionnaire at Month 1 | Baseline | 32.5 score on a scale | Standard Deviation 16.53 |
| Control Group: No Treatment Then Optional JUVÉDERM® VOLITE™ | Change From Baseline in Face-Q Satisfaction With Skin Questionnaire at Month 1 | Change from Baseline at Month 1 | 1.4 score on a scale | Standard Deviation 15.18 |
| JUVÉDERM VOLITE™ XC | Change From Baseline in Face-Q Satisfaction With Skin Questionnaire at Month 1 | Change from Baseline at Month 1 | 32.0 score on a scale | Standard Deviation 27.27 |
| JUVÉDERM VOLITE™ XC | Change From Baseline in Face-Q Satisfaction With Skin Questionnaire at Month 1 | Baseline | 34.3 score on a scale | Standard Deviation 17.11 |
Percentage of Participants With at Least 1-Point Improvement (Decreased) From Baseline on Both Cheeks in the Allergan Fine Lines Scale (AFLS) Response at Month 1
The AFLS is a validated 5-point ordinal scale developed by Allergan to grade the severity of fine lines on the cheeks. The score ranges from 0 (no fine lines) to 4 (diffuse superficial lines, crosshatching). Responders are participants with at least 1-point improvement (decrease) from baseline on the AFLS on both cheeks based on observed data of EI assessment. Baseline is the last non-missing EI assessment on or before the latter of randomization date or first study treatment date in the control period.
Time frame: Baseline to Month 1
Population: mITT Population included all randomized participants who had baseline assessment on the ACSS scale for both cheeks, and are not in the Fitzpatrick V/VI safety cohort. Overall number analyzed are the number of participants available for analyses.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Control Group: No Treatment Then Optional JUVÉDERM® VOLITE™ | Percentage of Participants With at Least 1-Point Improvement (Decreased) From Baseline on Both Cheeks in the Allergan Fine Lines Scale (AFLS) Response at Month 1 | 5.4 percentage of participants |
| JUVÉDERM VOLITE™ XC | Percentage of Participants With at Least 1-Point Improvement (Decreased) From Baseline on Both Cheeks in the Allergan Fine Lines Scale (AFLS) Response at Month 1 | 58.3 percentage of participants |