Introduction: no previously published botulinum toxin type A cosmetic trials included both physician and subject measures of onset.

Objective: determine physician- and subject-reported onset of onabotulinumtoxinA.

Methods: Two-center open-label, 14-day study in toxin-naive female patients with moderate-to-severe glabellar lines (GL) treated with 20-U onabotulinumtoxinA. Onset endpoint was categorical (physician assessed: days 2, 3, 4, 7 and 14; subject: 14-day diary). Subjects rated improvements in GL severity and completed the Facial Line Outcomes (FLO) and Self-Perception of Age (SPA) questionnaires.

Results: nearly half, 48 percent (n=45) of subjects, reported onset by day 1. Subject- and physician-reported onset rates, respectively, were 77 percent and 87 percent (day 2), 93 percent and 91 percent (day 3), 98 percent and 100 percent (day 4), and 100 percent thereafter. At all time points, FLO and SPA improved (P=0.008 and P=0.01, respectively). No serious adverse events occurred.

Conclusion: onabotulinumtoxinA provides rapid onset (one to two days) based on physician and subject assessment.

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