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BOTOX® (onabotulinumtoxinA) Treatment of Masseter Muscle Prominence

BOTOX® (onabotulinumtoxinA) Treatment of Masseter Muscle Prominence: A Phase 2b, Multicenter, Randomized, Double-Blind, Multi-Dose, Placebo-Controlled Study

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03861936
Enrollment
150
Registered
2019-03-05
Start date
2019-05-16
Completion date
2020-07-02
Last updated
2021-04-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Masseter Muscle Prominence

Brief summary

Based on the results of the Phase 2 Study 191622-130 \[NCT02010775\], the current Phase 2b study is designed to further evaluate the safety and efficacy of BOTOX® for the treatment of Masseter Muscle Prominence (MMP) in adults.

Interventions

BIOLOGICALOnabotulinumtoxinA

OnabotulinumtoxinA (botulinum toxin Type A;BOTOX®) administered intramuscularly to the bilateral masseter muscles on Day 1.

DRUGNormal saline

Normal saline (placebo) administered intramuscularly to the bilateral masseter muscles on Day 1.

Sponsors

Allergan
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes

Inclusion criteria

* Participant has bilateral MMP (identical grades for left and right masseter), as determined at the Day 1 visit by the investigator using the MMPS * Participant has bilateral MMP, as determined at the Day 1 visit by the participant using the Masseter Muscle Prominence Scale-Participant (MMPS-P) * Body mass index (BMI) ≤ 30 kilogram/square meter (kg/m\^2) using the calculation: BMI = weight (kg) \[height (m\^2)\] * Female participants willing to minimize the risk of inducing pregnancy for the duration of the clinical study and follow-up period. A female participant is eligible to participate if she is not pregnant (has a negative urine pregnancy result prior to randomization), not breastfeeding, and at least one of the following conditions applies: 1. Not a woman of childbearing potential (WOCBP) OR 2. A WOCBP who agrees to follow the contraceptive guidance during the treatment and follow-up period * Able, as assessed by the investigator, and willing to follow study instructions and likely to complete all required study visits.

Exclusion criteria

* Any medical condition that may put the participant at increased medical risk with exposure to BOTOX®, including diagnosed myasthenia gravis, Eaton-Lambert syndrome, amyotrophic lateral sclerosis, or any other condition that might interfere with neuromuscular function * Any uncontrolled medical condition * An anticipated need for surgery or overnight hospitalization during the study * An anticipated need for treatment with botulinum toxin of any serotype for any indication during the study (other than study intervention) * History of dental or surgical procedure for lower facial shaping or masseter muscle reduction * Prior mid-facial and/or lower facial treatment with nonpermanent soft tissue fillers, synthetic implantations, autologous fat transplantation, fat-reducing injectables, and/or skin-tightening laser treatments within 6 months of entry into the study * Current or planned dental or facial procedures during the study period (eg, braces, dental implants, and reconstructive or aesthetic surgery) that could interfere with MMPS, as determined by the investigator * Facial hair or scarring (eg, acne) significant enough to interfere with the 3D clinical photography assessment * Current enrollment in an investigational drug or device study or participation in such a study within 30 days of entry into this study * Prior exposure to botulinum toxin of any serotype to the masseter muscle or lower face at any time, or to any other part of the body within the 6 months prior to Day 1 * Current intraoral infection, including infection of the mouth or gums, or facial skin infection requiring medical treatment in the opinion of the investigator * History of or current Temporomandibular Joint Dysfunction (TMJD), or presence of signs/symptoms of possible TMJD, in the opinion of the investigator * Weakness of the masseter, pterygoid, or temporalis muscles due to trauma, facial nerve injury, or other condition that could interfere with normal chewing and jaw clenching, as determined by the investigator * Excess lower facial fat, loose or lax skin in lower face, or parotid gland prominence that could interfere with MMPS, as determined by the investigator * Significant asymmetry of left and right sides of the face that could prevent identical MMPS grading on both sides of the face, as determined by the investigator * Masseter prominence due to other etiologies (eg, parotid gland infection, parotiditis, malignancy) based upon findings from the oral examination.

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in Pulse RateBaseline (Day 1) to the End of Study (Up to Day 180) ]Pulse rate measures the number of times your heart beats per minute.
Percentage of Participants Who Achieved Masseter Muscle Prominence Scale (MMPS) Grade ≤ 3 at Day 90 as Assessed by the InvestigatorDay 90The investigator assessed the severity of the participant's masseter muscle prominence (MMP) using the MMPS 5-point scale where: 1=minimal (best), 2=mild, 3=moderate, 4=marked, and 5=very marked (worst). The percentage of participants where the investigator selected 1=minimal, 2=mild, or 3=moderate are reported.
Number of Participants With at Least One Treatment-emergent Adverse Event (TEAE)First dose (Day 1) to the End of Study (Up to Day 180)An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study intervention. A TEAE is an AE that occurs or worsens after receiving study drug.
Change From Baseline in Systolic Blood PressureBaseline (Day 1) to the End of Study (Up to Day 180)
Change From Baseline in Diastolic Blood PressureBaseline (Day 1) to the End of Study (Up to Day 180)
Change From Baseline in Respiratory RateBaseline (Day 1) to the End of Study (Up to Day 180)Respiratory rate is calculated as number of breaths (inhalation and exhalation) in one minute.

Secondary

MeasureTime frameDescription
Percentage of Participants Who Achieved Participant Masseter Muscle Prominence Scale-Participant (MMPS-P) Grade ≤ 3 at Day 90 as Assessed by the ParticipantDay 90The participant assessed the severity of their MMP using the MMPS-P 5-point scale where: 1=not at all pronounced (best), 2=mildly pronounced, 3=moderately pronounced, 4=pronounced, and 5=very pronounced (worst). The percentage of participants who selected 1=not at all pronounced, 2=mildly pronounced, or 3=moderately pronounced are reported.
Percentage of Participants Who Achieved ≥ 2-grade MMPS Improvement From Baseline at Day 90 as Assessed by the InvestigatorBaseline (Day 1) to Day 90The investigator assessed the severity of the participant's MMP using the MMPS 5-point scale where: 1=minimal (best), 2=mild, 3=moderate, 4=marked, and 5=very marked (worst). The percentage of participants who achieved a ≥ 2-grade improvement (decrease) from Baseline as assessed by the investigator are reported.
Percentage of Participants Who Achieved ≥ 2-grade MMPS-P Improvement From Baseline at Day 90 as Assessed by the ParticipantBaseline (Day 1) to Day 90The participant assessed the severity of their MMP using the MMPS-P 5-point scale where: 1=not at all pronounced (best), 2=mildly pronounced, 3=moderately pronounced, 4=pronounced, and 5=very pronounced (worst). The percentage of participants who achieved a ≥ 2-grade improvement (decrease) from Baseline as assessed by the participant are reported.
Percentage of Participants Who Achieved Participant Self-Assessment of Change (PSAC) in MMP Grade ≥ 2 (at Least Moderately Improved From Baseline) at Day 90Baseline (Day 1) to Day 90The participants assessed the degree of change of their MMP using a single item composed of 7 grades (3 to -3) where: 3=much improved, 2=moderately improved, 1=minimally improved, 0=no change, -1=minimally worse, -2=moderately worse, and -3=much worse. The percentage of participants where the participant selected 2=moderately improved, or 3=much improved as compared to Baseline are reported.
Change From Baseline in Lower Facial Volume at Day 90 Using Landmark Area of Interest (AOI) AnalysisBaseline (Day 1) to Day 90Lower facial volume was calculated from 3-dimensional (3D) surface images captured at Baseline and Day 90. The analysis region is defined using a series of anatomical landmarks placed on the baseline surface that are then projected mathematically to the posttreatment surface and verified by a technician. The difference in volume is measured between the select region of the baseline surface to the posttreatment surface. The lower facial volume is summed for both the left side and the right side of the face. An analysis of covariance (ANCOVA) model was used for analyses.
Change From Baseline in Lower Facial Volume at Day 90 Using Statistical MMP AOI AnalysisBaseline (Day 1) to Day 90Lower facial volume was calculated from 3D surface models of the full area of the lower face captured at Baseline and Day 90. The statistical MMP AOI method is based on a statistical shape averaging of the area of change post masseter treatment from multiple facial models. The difference in volume is calculated between the two 3D surface models at Baseline and Day 90. An ANCOVA model was used for analyses.

Countries

United States

Participant flow

Participants by arm

ArmCount
Placebo
Placebo (Normal saline) administered intramuscularly to the bilateral masseter muscles on Day 1.
46
BOTOX® 48U
OnabotulinumtoxinA (botulinum toxin Type A; BOTOX®) 48U total dose administered intramuscularly to the bilateral masseter muscles on Day 1.
53
BOTOX® 72U
OnabotulinumtoxinA (botulinum toxin Type A; BOTOX®) 72U total dose administered intramuscularly to the bilateral masseter muscles on Day 1.
46
Total145

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyLost to Follow-up533
Overall StudyPhysician Decision010
Overall StudyProtocol Deviation001
Overall StudyReason not Specified553
Overall StudyWithdrawal by Subject413

Baseline characteristics

CharacteristicPlaceboBOTOX® 48UBOTOX® 72UTotal
Age, Continuous41.0 years
STANDARD_DEVIATION 12.11
38.3 years
STANDARD_DEVIATION 10.5
38.9 years
STANDARD_DEVIATION 10.6
39.3 years
STANDARD_DEVIATION 11.05
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants13 Participants9 Participants26 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
42 Participants40 Participants37 Participants119 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
7 Participants8 Participants10 Participants25 Participants
Race (NIH/OMB)
Black or African American
2 Participants1 Participants3 Participants6 Participants
Race (NIH/OMB)
More than one race
1 Participants0 Participants1 Participants2 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants2 Participants0 Participants2 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
36 Participants42 Participants32 Participants110 Participants
Sex: Female, Male
Female
43 Participants45 Participants42 Participants130 Participants
Sex: Female, Male
Male
3 Participants8 Participants4 Participants15 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 480 / 530 / 49
other
Total, other adverse events
0 / 486 / 534 / 49
serious
Total, serious adverse events
1 / 481 / 530 / 49

Outcome results

Primary

Change From Baseline in Diastolic Blood Pressure

Time frame: Baseline (Day 1) to the End of Study (Up to Day 180)

Population: Safety Population consisted of all participants who received at least 1 injection of study intervention. Number analyzed is the number of participants with data available at the given time-point.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboChange From Baseline in Diastolic Blood PressureBaseline76.8 mmHgStandard Deviation 8.28
PlaceboChange From Baseline in Diastolic Blood PressureChange from Baseline to End of Study0.1 mmHgStandard Deviation 6.72
BOTOX® 48UChange From Baseline in Diastolic Blood PressureBaseline77.7 mmHgStandard Deviation 8.63
BOTOX® 48UChange From Baseline in Diastolic Blood PressureChange from Baseline to End of Study-0.2 mmHgStandard Deviation 8.07
BOTOX® 72UChange From Baseline in Diastolic Blood PressureBaseline76.6 mmHgStandard Deviation 10.09
BOTOX® 72UChange From Baseline in Diastolic Blood PressureChange from Baseline to End of Study0.8 mmHgStandard Deviation 9.44
Primary

Change From Baseline in Pulse Rate

Pulse rate measures the number of times your heart beats per minute.

Time frame: Baseline (Day 1) to the End of Study (Up to Day 180) ]

Population: Safety Population consisted of all participants who received at least 1 injection of study intervention. Number analyzed is the number of participants with data available at the given time-point.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboChange From Baseline in Pulse RateChange from Baseline to End of Study-0.2 beats/minuteStandard Deviation 10.69
PlaceboChange From Baseline in Pulse RateBaseline76.9 beats/minuteStandard Deviation 12.47
BOTOX® 48UChange From Baseline in Pulse RateChange from Baseline to End of Study-0.8 beats/minuteStandard Deviation 9.83
BOTOX® 48UChange From Baseline in Pulse RateBaseline73.9 beats/minuteStandard Deviation 10.83
BOTOX® 72UChange From Baseline in Pulse RateBaseline74.2 beats/minuteStandard Deviation 11.22
BOTOX® 72UChange From Baseline in Pulse RateChange from Baseline to End of Study0.9 beats/minuteStandard Deviation 10.59
Primary

Change From Baseline in Respiratory Rate

Respiratory rate is calculated as number of breaths (inhalation and exhalation) in one minute.

Time frame: Baseline (Day 1) to the End of Study (Up to Day 180)

Population: Safety Population consisted of all participants who received at least 1 injection of study intervention. Number analyzed is the number of participants with data available at the given time-point.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboChange From Baseline in Respiratory RateBaseline15.5 breaths/minuteStandard Deviation 2.01
PlaceboChange From Baseline in Respiratory RateChange from Baseline to End of Study0.1 breaths/minuteStandard Deviation 1.75
BOTOX® 48UChange From Baseline in Respiratory RateBaseline15.6 breaths/minuteStandard Deviation 2.14
BOTOX® 48UChange From Baseline in Respiratory RateChange from Baseline to End of Study0.1 breaths/minuteStandard Deviation 1.85
BOTOX® 72UChange From Baseline in Respiratory RateBaseline15.2 breaths/minuteStandard Deviation 1.92
BOTOX® 72UChange From Baseline in Respiratory RateChange from Baseline to End of Study0.1 breaths/minuteStandard Deviation 1.66
Primary

Change From Baseline in Systolic Blood Pressure

Time frame: Baseline (Day 1) to the End of Study (Up to Day 180)

Population: Safety Population consisted of all participants who received at least 1 injection of study intervention. Number analyzed is the number of participants with data available at the given time-point.

ArmMeasureGroupValue (MEAN)Dispersion
PlaceboChange From Baseline in Systolic Blood PressureBaseline115.8 millimeters of mercury (mmHg)Standard Deviation 13.52
PlaceboChange From Baseline in Systolic Blood PressureChange from Baseline to End of Study-0.3 millimeters of mercury (mmHg)Standard Deviation 10.09
BOTOX® 48UChange From Baseline in Systolic Blood PressureBaseline118.6 millimeters of mercury (mmHg)Standard Deviation 10.39
BOTOX® 48UChange From Baseline in Systolic Blood PressureChange from Baseline to End of Study-1.2 millimeters of mercury (mmHg)Standard Deviation 12.05
BOTOX® 72UChange From Baseline in Systolic Blood PressureBaseline114.7 millimeters of mercury (mmHg)Standard Deviation 13.64
BOTOX® 72UChange From Baseline in Systolic Blood PressureChange from Baseline to End of Study-0.3 millimeters of mercury (mmHg)Standard Deviation 10.82
Primary

Number of Participants With at Least One Treatment-emergent Adverse Event (TEAE)

An adverse event (AE) is any untoward medical occurrence in a patient or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of study intervention. A TEAE is an AE that occurs or worsens after receiving study drug.

Time frame: First dose (Day 1) to the End of Study (Up to Day 180)

Population: Safety Population consisted of all participants who received at least 1 injection of study intervention.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
PlaceboNumber of Participants With at Least One Treatment-emergent Adverse Event (TEAE)12 Participants
BOTOX® 48UNumber of Participants With at Least One Treatment-emergent Adverse Event (TEAE)18 Participants
BOTOX® 72UNumber of Participants With at Least One Treatment-emergent Adverse Event (TEAE)14 Participants
Primary

Percentage of Participants Who Achieved Masseter Muscle Prominence Scale (MMPS) Grade ≤ 3 at Day 90 as Assessed by the Investigator

The investigator assessed the severity of the participant's masseter muscle prominence (MMP) using the MMPS 5-point scale where: 1=minimal (best), 2=mild, 3=moderate, 4=marked, and 5=very marked (worst). The percentage of participants where the investigator selected 1=minimal, 2=mild, or 3=moderate are reported.

Time frame: Day 90

Population: mITT Population consisted of all randomized participants who received study treatment and had at least 1 postbaseline MMPS assessment.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Masseter Muscle Prominence Scale (MMPS) Grade ≤ 3 at Day 90 as Assessed by the Investigator21.7 percentage of participants
BOTOX® 48UPercentage of Participants Who Achieved Masseter Muscle Prominence Scale (MMPS) Grade ≤ 3 at Day 90 as Assessed by the Investigator90.6 percentage of participants
BOTOX® 72UPercentage of Participants Who Achieved Masseter Muscle Prominence Scale (MMPS) Grade ≤ 3 at Day 90 as Assessed by the Investigator91.3 percentage of participants
p-value: <0.000195% CI: [54.5, 83.1]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [55.1, 84]Cochran-Mantel-Haenszel
Secondary

Change From Baseline in Lower Facial Volume at Day 90 Using Landmark Area of Interest (AOI) Analysis

Lower facial volume was calculated from 3-dimensional (3D) surface images captured at Baseline and Day 90. The analysis region is defined using a series of anatomical landmarks placed on the baseline surface that are then projected mathematically to the posttreatment surface and verified by a technician. The difference in volume is measured between the select region of the baseline surface to the posttreatment surface. The lower facial volume is summed for both the left side and the right side of the face. An analysis of covariance (ANCOVA) model was used for analyses.

Time frame: Baseline (Day 1) to Day 90

Population: mITT Population consisted of all randomized participants who received study treatment and had at least 1 postbaseline MMPS assessment. Missing postbaseline data are imputed using LOCF.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Lower Facial Volume at Day 90 Using Landmark Area of Interest (AOI) Analysis-0.33 cubic centimeter (cm^3)Standard Error 0.511
BOTOX® 48UChange From Baseline in Lower Facial Volume at Day 90 Using Landmark Area of Interest (AOI) Analysis-6.15 cubic centimeter (cm^3)Standard Error 0.475
BOTOX® 72UChange From Baseline in Lower Facial Volume at Day 90 Using Landmark Area of Interest (AOI) Analysis-6.14 cubic centimeter (cm^3)Standard Error 0.505
p-value: <0.000195% CI: [-7.1, -4.54]ANCOVA
p-value: <0.000195% CI: [-7.15, -4.47]ANCOVA
Secondary

Change From Baseline in Lower Facial Volume at Day 90 Using Statistical MMP AOI Analysis

Lower facial volume was calculated from 3D surface models of the full area of the lower face captured at Baseline and Day 90. The statistical MMP AOI method is based on a statistical shape averaging of the area of change post masseter treatment from multiple facial models. The difference in volume is calculated between the two 3D surface models at Baseline and Day 90. An ANCOVA model was used for analyses.

Time frame: Baseline (Day 1) to Day 90

Population: mITT Population consisted of all randomized participants who received study treatment and had at least 1 postbaseline MMPS assessment. Missing postbaseline data are imputed using LOCF.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
PlaceboChange From Baseline in Lower Facial Volume at Day 90 Using Statistical MMP AOI Analysis-0.09 cm^3Standard Error 0.598
BOTOX® 48UChange From Baseline in Lower Facial Volume at Day 90 Using Statistical MMP AOI Analysis-7.72 cm^3Standard Error 0.555
BOTOX® 72UChange From Baseline in Lower Facial Volume at Day 90 Using Statistical MMP AOI Analysis-8.35 cm^3Standard Error 0.59
p-value: <0.000195% CI: [-9.12, -6.13]ANCOVA
p-value: <0.000195% CI: [-9.83, -6.69]ANCOVA
Secondary

Percentage of Participants Who Achieved ≥ 2-grade MMPS Improvement From Baseline at Day 90 as Assessed by the Investigator

The investigator assessed the severity of the participant's MMP using the MMPS 5-point scale where: 1=minimal (best), 2=mild, 3=moderate, 4=marked, and 5=very marked (worst). The percentage of participants who achieved a ≥ 2-grade improvement (decrease) from Baseline as assessed by the investigator are reported.

Time frame: Baseline (Day 1) to Day 90

Population: mITT Population consisted of all randomized participants who received study treatment and had at least 1 postbaseline MMPS assessment. Missing postbaseline data are imputed using LOCF.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved ≥ 2-grade MMPS Improvement From Baseline at Day 90 as Assessed by the Investigator10.9 percentage of participants
BOTOX® 48UPercentage of Participants Who Achieved ≥ 2-grade MMPS Improvement From Baseline at Day 90 as Assessed by the Investigator66.0 percentage of participants
BOTOX® 72UPercentage of Participants Who Achieved ≥ 2-grade MMPS Improvement From Baseline at Day 90 as Assessed by the Investigator71.7 percentage of participants
p-value: <0.000195% CI: [39.6, 70.8]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [45.1, 76.7]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants Who Achieved ≥ 2-grade MMPS-P Improvement From Baseline at Day 90 as Assessed by the Participant

The participant assessed the severity of their MMP using the MMPS-P 5-point scale where: 1=not at all pronounced (best), 2=mildly pronounced, 3=moderately pronounced, 4=pronounced, and 5=very pronounced (worst). The percentage of participants who achieved a ≥ 2-grade improvement (decrease) from Baseline as assessed by the participant are reported.

Time frame: Baseline (Day 1) to Day 90

Population: mITT Population consisted of all randomized participants who received study treatment and had at least 1 postbaseline MMPS assessment. Missing postbaseline data are imputed using LOCF.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved ≥ 2-grade MMPS-P Improvement From Baseline at Day 90 as Assessed by the Participant32.6 percentage of participants
BOTOX® 48UPercentage of Participants Who Achieved ≥ 2-grade MMPS-P Improvement From Baseline at Day 90 as Assessed by the Participant86.8 percentage of participants
BOTOX® 72UPercentage of Participants Who Achieved ≥ 2-grade MMPS-P Improvement From Baseline at Day 90 as Assessed by the Participant80.4 percentage of participants
p-value: <0.000195% CI: [37.9, 70.5]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [30.1, 65.6]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants Who Achieved Participant Masseter Muscle Prominence Scale-Participant (MMPS-P) Grade ≤ 3 at Day 90 as Assessed by the Participant

The participant assessed the severity of their MMP using the MMPS-P 5-point scale where: 1=not at all pronounced (best), 2=mildly pronounced, 3=moderately pronounced, 4=pronounced, and 5=very pronounced (worst). The percentage of participants who selected 1=not at all pronounced, 2=mildly pronounced, or 3=moderately pronounced are reported.

Time frame: Day 90

Population: mITT Population consisted of all randomized participants who received study treatment and had at least 1 postbaseline MMPS assessment. Missing postbaseline data are imputed using last observation carried forward (LOCF).

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Participant Masseter Muscle Prominence Scale-Participant (MMPS-P) Grade ≤ 3 at Day 90 as Assessed by the Participant47.8 percentage of participants
BOTOX® 48UPercentage of Participants Who Achieved Participant Masseter Muscle Prominence Scale-Participant (MMPS-P) Grade ≤ 3 at Day 90 as Assessed by the Participant96.2 percentage of participants
BOTOX® 72UPercentage of Participants Who Achieved Participant Masseter Muscle Prominence Scale-Participant (MMPS-P) Grade ≤ 3 at Day 90 as Assessed by the Participant93.5 percentage of participants
p-value: <0.000195% CI: [29.5, 61.8]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [33.1, 63.7]Cochran-Mantel-Haenszel
Secondary

Percentage of Participants Who Achieved Participant Self-Assessment of Change (PSAC) in MMP Grade ≥ 2 (at Least Moderately Improved From Baseline) at Day 90

The participants assessed the degree of change of their MMP using a single item composed of 7 grades (3 to -3) where: 3=much improved, 2=moderately improved, 1=minimally improved, 0=no change, -1=minimally worse, -2=moderately worse, and -3=much worse. The percentage of participants where the participant selected 2=moderately improved, or 3=much improved as compared to Baseline are reported.

Time frame: Baseline (Day 1) to Day 90

Population: mITT Population consisted of all randomized participants who received study treatment and had at least 1 postbaseline MMPS assessment. Missing postbaseline data are imputed using LOCF.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Participant Self-Assessment of Change (PSAC) in MMP Grade ≥ 2 (at Least Moderately Improved From Baseline) at Day 9021.7 percentage of participants
BOTOX® 48UPercentage of Participants Who Achieved Participant Self-Assessment of Change (PSAC) in MMP Grade ≥ 2 (at Least Moderately Improved From Baseline) at Day 9090.6 percentage of participants
BOTOX® 72UPercentage of Participants Who Achieved Participant Self-Assessment of Change (PSAC) in MMP Grade ≥ 2 (at Least Moderately Improved From Baseline) at Day 9073.9 percentage of participants
p-value: <0.000195% CI: [54.5, 83.1]Cochran-Mantel-Haenszel
p-value: <0.000195% CI: [34.8, 69.6]Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026