Understanding DAXXIFY®: A Longer-Lasting Botox alternative
Karli Plunkett, DMSc, PA-C, LME
August 04, 2023
6 min read
Daxxify is a groundbreaking neuromodulator developed by Revance Therapeutics. It has received approval from the U.S. Food and Drug Administration (FDA) as a safe and effective glabellar lines (AKA frown wrinkles) treatment. This innovative product joins the ranks of other FDA-approved neuromodulators for aesthetic treatments, such as Botox, Dysport, Xeomin, and Jeuveau. However, Daxxify distinguishes itself from its predecessors with its unique peptide exchange technology, which allows it to maintain its effects at the neuromuscular junction for a longer duration.
A Primer on Neuromodulators
To fully appreciate the innovation that Daxxify brings to the table, it's essential to understand what neuromodulators are and how they work. Neuromodulators are substances that alter nerve impulse transmission. In the context of aesthetic treatments, these substances are used to reduce the appearance of wrinkles and fine lines. They achieve this by blocking the communication between nerves and muscles, preventing muscle contraction despite the nerve signals. This temporary paralysis and relaxation of facial muscles prevents the creation and worsening of facial lines and wrinkles.
Daxxify: A Close Look
Daxxify, also known as daxibotulinumtoxina-lanm or Daxi, like its counterparts, is a neuromodulator. However, it's not just any neuromodulator. It's a botulinum toxin type A, the same active ingredient found in Botox and Dysport. But while the active ingredient may be the same, the formulation and the effects are not. Daxxify is formulated with a unique peptide exchange technology, and is the first botulinum toxin injectable made without any human or animal products. For instance, BOTOX® Cosmetic employs human serum albumin (HSA), a substance derived from blood, to ensure its stability. Dysport® also uses HSA for stabilization, in addition to cow's milk protein. Daxxify's peptide technology allows it to remain stable and effective at the neuromuscular junction for a longer period, leading to longer-lasting results.
The primary use of Daxi is to treat and prevent severe frown lines, also known as glabellar lines. These are the facial lines that form between our eyebrows due to the action of frowning. However, the potential applications of Daxxify extend beyond aesthetic treatments. Revance Therapeutics has also submitted an application for the FDA approval of Daxxify for the treatment of cervical dystonia, a painful neuromuscular condition affecting the muscles of the neck.
Daxxify Clinical Trials & FDA Approval
The FDA's approval of Daxxify was based on extensive clinical trial data. 2,823 patients participated in these trials, receiving a total of 4,444 treatments. The results were impressive: one month after the injections, 98 percent of patients had little or no appearance of wrinkles. Even more striking, over half of the patients had maintained measurable results at the injection area after six months. Some patients even reported results lasting up to nine months. These results underscore the effectiveness and longevity of Daxxify's unique formulation.
Daxxify vs. Botox for Long-term Wrinkle Reduction
The most significant difference between Daxi and other neuromodulators lies in its duration of efficacy. While most neurotoxins on the market report an average duration of three to four months, Daxxify lasts for an average of six months, or possibly longer, as demonstrated in their clinical trials. This longer-lasting effect is attributed to Daxxify's unique peptide formulation.
This extended duration of effect means that patients using Daxxify would need fewer treatments per year compared to those using other neuromodulators. This means less time spent at the med spa and more facial consistency throughout the year.
Daxxify Risk of Complications
Like all treatments, Daxxify comes with potential risks and complications. In clinical trials, the most common side effects were headaches, experienced by 6% of users, followed by drooping eyelids, experienced by 2% of users, and facial asymmetry, experienced by 1% of users. Postmarketing safety data from other approved botulinum toxins suggest that botulinum toxin effects may be observed beyond the site of local injection. These symptoms, consistent with the mechanism of action of botulinum toxin, may include asthenia, generalized muscle weakness, diplopia, blurred vision, ptosis, dysphagia, dysphonia, dysarthria, urinary incontinence, and breathing difficulties. These symptoms have been reported hours to weeks after injection. Swallowing and breathing difficulties can be life-threatening, and there have been reports of death related to the spread of toxin effects.
Longer results also mean that if a patient is not happy with the outcome, they cannot undo it for a longer period. Therefore, it is recommended that Daxxify may be more appropriate for people who have tried another injectable first and are happy with their injection pattern.
Unpacking the Studies on Longevity
Both Allergan, the company behind BOTOX, and Revance, the creator of Daxxify, have conducted comprehensive clinical trials to examine the duration of their products' effects. The studies revealed that Botox could yield longer-lasting results when administered in larger quantities. This is significant as Daxxify has recommended using double the units often recommended for Botox.
This led me to ask: Does Daxi actually last longer, or are they just recommending higher dosages?
The research provides some clarity. To start, research from both sides measured results based on respondents achieving FWS (Frown Wrinkle Severity) ≥1 over the duration of their studies. The FWS scale includes ratings of 0 (none), 1 (mild), 2 (moderate), and 3 (severe).
The study on Botox showed that doubling the dosage to 40 units led to about half of the participants achieving an improvement of around 20 weeks, and 32% maintaining an improvement at the 24 week mark. For Daxxify, half of the patients still showed an improvement of at 24 weeks.
While we don't recommend waiting until the effects completely wear off before getting another treatment, the studies did look at how long it took for the results to revert to the baseline. For all Botox groups receiving 40U, 60U, and 80U, this occurred at 24 weeks, while for the Daxxify group, it took 28 weeks.
Remarkably, this means that 40U of Daxxify lasted longer than even 60U and 80U of Botox in the glabellar region. This is strong evidence that Daxxify's formulation may indeed offer superior longevity.
The studies also revealed some interesting similarities. The average participant age was around 48 in the Botox study and about 50 in the Daxxify study. Surprisingly, in both studies, 39% of patients had "moderate" Frown Wrinkle Severity (FWS-2), and 61% had "severe" Frown Wrinkle Severity (FWS-3).
Speed of Initial Wrinkle Results
What is the cost of Daxxify vs Botox?
In Daxxify trials, the median time to onset of a clinically meaningful response was 3 days in each study, which is about in line with Botox and Dysport. Most patients saw full results within 2 weeks of injections.
DAXXIFY usually costs between $15 and $25 per unit, though we reduce your first DAXXIFY treatment to $11-13 (the cost of BOTOX). Future DAXXIFY treatments are $12-14 per unit, a $1 premium over BOTOX. Botox typically ranges from $10 to $15 per unit. Our members pay $11 per unit, and non-members pay $13/unit. Memberships start at $20/month.
It's important to remember that because Daxxify lasts longer than BOTOX and Dysport, you need to have more faith in your provider to know your dosage and be precise.
Neuromodulator Breakthrough of the Decade
In conclusion, Daxxify represents a significant advancement in the field of anti-wrinkle treatments. Its longer-lasting effects and unique peptide formulation offer a promising alternative to existing treatments. However, like all treatments, it comes with potential risks and complications, and users should be fully aware of these before deciding to use Daxxify.
To you're a potential Orlando Daxxify patient, learn more on our Daxxify page or book an appointment at our Orlando, Florida practice today.