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

A Prospective, Randomized, Double-blind, Placebo-controlled, Multicenter Study With an Open-label Extension Period to Investigate the Efficacy and Safety of NT 201 in the Simultaneous Treatment of Upper Facial Lines (Horizontal Forehead Lines, Glabellar Frown Lines, and Lateral Canthal Lines)

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04594213
Acronym
ULTRA I
Enrollment
362
Registered
2020-10-20
Start date
2020-09-23
Completion date
2022-05-09
Last updated
2024-05-08

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

Conditions

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

Brief 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.

Interventions

DRUGNT 201

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

DRUGPlacebo

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

Sponsors

Merz Pharmaceuticals GmbH
CollaboratorINDUSTRY
Merz North America, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

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

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

* 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.

Design outcomes

Primary

MeasureTime frameDescription
Main Period: Percentage of Glabellar Frown Line (GFL) Responders at Day 30Day 30The 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.
Main Period: Percentage of Horizontal Forehead Lines (HFL) Responders at Day 30Day 30The 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.
Main Period: Percentage of Lateral Canthal Lines (LCL) Responders at Day 30Day 30The 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.

Secondary

MeasureTime frameDescription
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 30Day 30The 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.
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 30Day 30The 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.
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 30Day 30The 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.
Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the SubjectsDay 30The 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.
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for GFL at Maximum Contraction as Assessed by the InvestigatorDay 30The 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.
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 30Day 30The 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.
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the InvestigatorDay 30The 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.
Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the InvestigatorDay 30The 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.
Main Period: Number of Subjects With Related Treatment-Emergent Adverse Events (TEAEs)Up to 22 WeeksTEAEs 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.
OLEX Period: Number of Subjects With Related TEAEsUp to 39 WeeksTEAEs of the OLEX period are defined as 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.
Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for HFL at Maximum Contraction as Assessed by the InvestigatorDay 30The 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.
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 30Day 30The 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.
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 30Day 30The 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.

Countries

United States

Participant flow

Recruitment details

Subjects were recruited at 12 investigational sites in the United States.

Pre-assignment details

Of the 420 screened subjects, 58 subjects exited as screen failures and 362 subjects were randomized and enrolled to receive a treatment with NT 201 or placebo in the main period of the study. Out of 350 subjects who completed the main period, only 303 subjects received treatment in the open-label extension (OLEX) period of the study.

Participants by arm

ArmCount
Main Period: Placebo (Group P)
Subjects received placebo injection in all three UFL (GFL, HFL and LCL) on Day 1 of main period.
91
Main Period: NT 201 (Group U)
Subjects received a total of 64 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.
179
Main Period: NT 201 and Placebo (Group G and H)
Subjects received a total of 40 U of NT 201: 20 U of NT 201 injection both in the GFL and HFL area, and placebo injection in the LCL area on Day 1 of main period.
92
Total362

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005
Main Period (Up to 22 Weeks)Lost to Follow-up101000
Main Period (Up to 22 Weeks)Physician Decision010000
Main Period (Up to 22 Weeks)Withdrawal by Subject261000
OLEX Period (Up to 39 Weeks)Adverse Event000020
OLEX Period (Up to 39 Weeks)Lost to Follow-up000462
OLEX Period (Up to 39 Weeks)No need for re-injection0007225
OLEX Period (Up to 39 Weeks)Other000131
OLEX Period (Up to 39 Weeks)Other eligibility criteria for re-injection not met000100
OLEX Period (Up to 39 Weeks)Pregnancy000001
OLEX Period (Up to 39 Weeks)Protocol Violation000100
OLEX Period (Up to 39 Weeks)Withdrawal by Subject0006114

Baseline characteristics

CharacteristicMain Period: Placebo (Group P)Main Period: NT 201 (Group U)Main Period: NT 201 and Placebo (Group G and H)Total
Age, Continuous47.5 years
STANDARD_DEVIATION 12.99
47.2 years
STANDARD_DEVIATION 13.21
47.8 years
STANDARD_DEVIATION 13.47
47.4 years
STANDARD_DEVIATION 13.19
Ethnicity (NIH/OMB)
Hispanic or Latino
28 Participants49 Participants29 Participants106 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
63 Participants130 Participants63 Participants256 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Asian
2 Participants7 Participants3 Participants12 Participants
Race (NIH/OMB)
Black or African American
7 Participants20 Participants7 Participants34 Participants
Race (NIH/OMB)
More than one race
2 Participants2 Participants2 Participants6 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
79 Participants150 Participants80 Participants309 Participants
Sex: Female, Male
Female
79 Participants154 Participants75 Participants308 Participants
Sex: Female, Male
Male
12 Participants25 Participants17 Participants54 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
0 / 910 / 1790 / 920 / 860 / 1440 / 73
other
Total, other adverse events
10 / 9118 / 1797 / 9216 / 8615 / 1445 / 73
serious
Total, serious adverse events
1 / 910 / 1791 / 921 / 862 / 1440 / 73

Outcome results

Primary

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

Population: Target population of main primary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)Main Period: Percentage of Glabellar Frown Line (GFL) Responders at Day 300 percentage of subjects
Main Period: NT 201 (Group U)Main Period: Percentage of Glabellar Frown Line (GFL) Responders at Day 3052.3 percentage of subjects
p-value: <0.0001Mantel Haenszel
Primary

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

Population: Target population of main primary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)Main Period: Percentage of Horizontal Forehead Lines (HFL) Responders at Day 300 percentage of subjects
Main Period: NT 201 (Group U)Main Period: Percentage of Horizontal Forehead Lines (HFL) Responders at Day 3066.5 percentage of subjects
p-value: <0.0001Mantel Haenszel
Primary

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

Population: Target population of main primary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)Main Period: Percentage of Lateral Canthal Lines (LCL) Responders at Day 300 percentage of subjects
Main Period: NT 201 (Group U)Main Period: Percentage of Lateral Canthal Lines (LCL) Responders at Day 3051.7 percentage of subjects
p-value: <0.0001Mantel Haenszel
Secondary

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

Population: FAS. Here overall number of subjects analyzed were subjects who had non-missing data for this outcome measure.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Main Period: Placebo (Group P)Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Investigator0.05 score on a scale
Main Period: NT 201 (Group U)Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Investigator2.43 score on a scale
Main Period: NT 201 and Placebo (Group G and H)Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Investigator1.99 score on a scale
p-value: <0.0001ANCOVA
p-value: <0.0001ANCOVA
Secondary

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

Population: Target population of main key secondary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Main Period: Placebo (Group P)Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Subjects0.08 score on a scale
Main Period: NT 201 (Group U)Main Period: Global Aesthetic Improvement Scale (GAIS) at Day 30 as Assessed by the Subjects2.24 score on a scale
p-value: <0.0001ANCOVA
Secondary

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

Population: The Safety Evaluation Set (SES) included all subjects treated.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Main Period: Placebo (Group P)Main Period: Number of Subjects With Related Treatment-Emergent Adverse Events (TEAEs)2 Participants
Main Period: NT 201 (Group U)Main Period: Number of Subjects With Related Treatment-Emergent Adverse Events (TEAEs)11 Participants
Main Period: NT 201 and Placebo (Group G and H)Main Period: Number of Subjects With Related Treatment-Emergent Adverse Events (TEAEs)6 Participants
Secondary

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 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

Population: Target population of main key secondary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)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 303.3 percentage of subjects
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 3081.3 percentage of subjects
p-value: <0.0001Mantel Haenszel
Secondary

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 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

Population: Target population of main key secondary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)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 303.3 percentage of subjects
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 3065.9 percentage of subjects
p-value: <0.0001Mantel Haenszel
Secondary

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 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

Population: Target population of main key secondary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)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 percentage of subjects
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 3088.6 percentage of subjects
p-value: <0.0001Mantel Haenszel
Secondary

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 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

Population: Target population of main key secondary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)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 302.2 percentage of subjects
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 3075.6 percentage of subjects
p-value: <0.0001Mantel Haenszel
Secondary

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 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

Population: Target population of main key secondary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)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 300 percentage of subjects
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 3092.0 percentage of subjects
p-value: <0.0001Mantel Haenszel
Secondary

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 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

Population: Target population of main key secondary estimand included subjects with HFL, GFL and LCL of moderate to severe intensity at maximum contraction as assessed by investigator and subject according to MAS, as randomized in this study: Subset of subjects randomized to UFL (Group U) or to placebo (Group P) groups, grouped by randomized treatment assignment.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)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 301.1 percentage of subjects
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 3077.3 percentage of subjects
p-value: <0.0001Mantel Haenszel
Secondary

Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 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

Population: FAS. Here overall number of subjects analyzed were subjects who had non-missing data for this outcome measure.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator7.9 percentage of subjects
Main Period: NT 201 (Group U)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator89.0 percentage of subjects
Main Period: NT 201 and Placebo (Group G and H)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for Both Left and Right LCL at Maximum Contraction as Assessed by the Investigator29.3 percentage of subjects
p-value: <0.0001Mantel Haenszel
Secondary

Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 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

Population: FAS. Here overall number of subjects analyzed were subjects who had non-missing data for this outcome measure.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for GFL at Maximum Contraction as Assessed by the Investigator1.1 percentage of subjects
Main Period: NT 201 (Group U)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for GFL at Maximum Contraction as Assessed by the Investigator96.5 percentage of subjects
Main Period: NT 201 and Placebo (Group G and H)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for GFL at Maximum Contraction as Assessed by the Investigator96.7 percentage of subjects
p-value: <0.0001Mantel Haenszel
p-value: <0.0001Mantel Haenszel
Secondary

Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 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

Population: FAS. Here overall number of subjects analyzed were subjects who had non-missing data for this outcome measure.

ArmMeasureValue (NUMBER)
Main Period: Placebo (Group P)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for HFL at Maximum Contraction as Assessed by the Investigator2.2 percentage of subjects
Main Period: NT 201 (Group U)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for HFL at Maximum Contraction as Assessed by the Investigator96.0 percentage of subjects
Main Period: NT 201 and Placebo (Group G and H)Main Period: Percentage of Subjects With at Least One-grade Improvement From Baseline to Day 30 on MAS for HFL at Maximum Contraction as Assessed by the Investigator96.7 percentage of subjects
p-value: <0.0001Mantel Haenszel
p-value: <0.0001Mantel Haenszel
Secondary

OLEX Period: Number of Subjects With Related TEAEs

TEAEs of the OLEX period are defined as 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

Population: SES.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Main Period: Placebo (Group P)OLEX Period: Number of Subjects With Related TEAEs10 Participants
Main Period: NT 201 (Group U)OLEX Period: Number of Subjects With Related TEAEs6 Participants
Main Period: NT 201 and Placebo (Group G and H)OLEX Period: Number of Subjects With Related TEAEs3 Participants

Source: ClinicalTrials.gov · Data processed: Feb 5, 2026