Sequential Treatment With BELKYRA® Then Juvéderm® VOLUMA™ With Lidocaine for Overall Improvement in Jawline Contour

Study Overview
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Brief Summary
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This study has been designed to evaluate the safety and effectiveness of sequential treatment with BELKYRA® (for the treatment of convexity and fullness associated with submental fat) and VOLUMA™ (to restore volume along the mandibular border) to enhance the overall contour of the jawline.

Detailed Description
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Participants may be treated with up to 6 treatments with Belkyra, followed by treatment with Voluma. Participants will have opportunity to participation in a skin biopsy sub-study.

Official Title
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A Prospective, Open-label Study to Evaluate Sequential Treatment With BELKYRA® and Juvéderm® VOLUMA™ With Lidocaine for Overall Improvement in Jawline Contour

Conditions
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Contour

Intervention / Treatment
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* Drug: BELKYRA®
* Device: Juvéderm® VOLUMA™ with Lidocaine


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Grade 2 or above on Allergan Loss of Jawline Definition Scale (ALJDS) Grade 2 or 3 on reported Clinician-Rated Submental Fat Rating Scale (CR-SMFRS) Stable body weight for at least 26 weeks Accept the obligation to forego any treatment or behavior (e.g., unshaven facial hair; significant changes to dietary or exercise habits) during the participants participation in the study that may affect the assessments of the submental area Exclusion Criteria: Grade 4 on Submental Skin Laxity Grade (SMSLG) Grade 4 on Allergan Jowl Fat Rating Scale (AJFRS) Body mass index (BMI) >35 kg/m^2 History of, or current symptoms of dysphagia History of temporary, semi-permanent or permanent facial or neck dermal filler injections below the medial canthi at any time prior to treatment, or within 52 weeks before Screening for treatment above the medial canthi History of facial and/or neck plastic surgery, tissue grafting or permanent facial implants anywhere in the face or neck History of any intervention (e.g., liposuction, surgery, or lipolytic agents) to treat submental fat (SMF) Evidence of any cause of enlargement in the submental area other than localized SMF History of mesotherapy or ablative procedures to the face and/or neck 52 weeks before Screening History of skin resurfacing in the neck or submental area within 26 weeks before Screening Treatment with botulinum toxin injections in the neck or submental area within 26 weeks before Screening Participants on prescription topical retinoid therapy and/or topical hormone cream applied to the face, who have not been on a consistent dose regimen for at least 26 weeks before Screening and who are unable to maintain regimen for the study Systemic retinoid therapy within 52 weeks before Screening Current use of oral corticosteroids Is on a regimen of anticoagulation therapy (eg, warfarin, clopidogrel) Has current injection site inflammatory or infectious processes, abscess, an unhealed wound, or a known cancerous or precancerous lesion in chin, masseter, or submental region Planned oral surgery or other dental procedures (e.g., tooth extraction, orthodontia, or implantation) within 2 weeks prior to and after VOLUMA™ treatment

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: BELKYRA® and Juvéderm® VOLUMA™ with Lidocaine<br>BELKYRA® was injected into subcutaneous preplatysma fat tissue in the submental area (at least 1 plus up to 5 optional treatments, for maximum of 6 treatments 8 weeks apart). When the investigator and participant agreed that no further intervention was required to achieve the desired result, participants were eligible to receive VOLUMA™ treatment. VOLUMA™ was injected along the mandibular border, with an optional touch-up visit 2 weeks later if applicable. | Drug: BELKYRA®<br>* BELKYRA® was injected into preplatysma fat tissue in the submental area (at least 1 plus up to 5 optional treatments, for maximum of 6 treatments 8 weeks apart).<br>Device: Juvéderm® VOLUMA™ with Lidocaine<br>* Juvéderm® VOLUMA™ with Lidocaine VOLUMA™ was injected along the mandibular border.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of Participants Who Showed ≥ 1-point Jawline Improvement From Baseline on the Allergan Loss of Jawline Definition Scale (ALJDS), as Assessed by the Investigator | The ALJDS was an investigator assessment of loss of jawline definition measured by a 5-point scale where: 0=none, 1=mild, 2=moderate, 3=severe, 4=extreme. Data is reported for both sides of the face, right side of the face and left side of the face. | Baseline (Day 0) to Week 58 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mean Change From Baseline to Last BELKYRA® Treatment on the ALJDS | The ALJDS was an investigator and independent reviewer assessment of jawline contour measured by a 5-point scale where: 0=none, 1=mild, 2=moderate, 3=severe, 4=extreme. A negative change from baseline indicated improvement. The data is reported for both sides of the face, right side of the face and left side of the face. | Baseline (Day 0) to Last Treatment (Up to Week 48) | 
| Mean Change From Baseline to Final Study Visit in the FACE-Q™ Satisfaction With Lower Face and Jawline Score | The participant assessed satisfaction using the 5 items on the Satisfaction of Lower Face and Jawline module of the FACE-Q™ questionnaire, measured on a 4-point scale where: 1=very dissatisfied, 2=somewhat dissatisfied, 3=somewhat satisfied, 4=very satisfied. The Rasch transformed scale total score was 0 (worst) to 100 (best). A positive change from baseline indicated improvement. | Baseline (Day 0) to Week 58 | 
| Mean Change From Baseline to Final Study Visit in the FACE-Q™ Appraisal of Neck | The participant assessed satisfaction using the 10 items on the Appraisal of Neck module of the FACE-Q™ questionnaire measured on a 4-point scale where: 1=not at all, 2=a little, 3=moderately, 4=extremely. The Rasch transformed scale total score was 0 (worst) to 100 (best). A positive change from baseline indicated improvement. | Baseline (Day 0) to Week 58 | 
| Mean Change From Baseline to Final Study Visit for FACE-Q™ Appraisal of Area Under Chin | The participant assessed satisfaction using the 5 items on the Appraisal of Area Under Chin module of the FACE-Q™ questionnaire measured on a 4-point scale where: 1=not at all, 2=a little, 3=moderately, 4=extremely. The Rasch transformed scale total score was 0 (worst) to 100 (best). A negative change from baseline indicated worsening. | Baseline (Day 0) to Week 58 | 
| Mean Change From Baseline to Final Study Visit for Clinician-Reported Submental Fat Rating Scale (CR-SMFRS) | The CR-SMFRS score was based on the investigator's clinical evaluation of the participant, where submental fullness was scored on a 5-point scale where: 0=absent, 1=mild, 2=moderate, 3=severe, and 4=extreme. A negative change from baseline indicated improvement. | Baseline (Day 0) to Week 58 | 
| Mean Change From Baseline to Final Study Visit for Patient-Reported Submental Fat Rating Scale (PR-SMFRS) | The PR-SMFRS was based on the participant's response to the question How much fat do you have under your chin right now? and answered on a 5-point ordinal scale where: 0=no chin fat at all, 1=a slight amount of chin fat, 2=a moderate amount of chin fat, 3=a large amount of chin fat, and 4=a very large amount of chin fat. A negative change from baseline indicated improvement. | Baseline (Day 0) to Week 58 | 
| Mean Change From Baseline to Final Study Visit for Submental Skin Laxity Grade (SMSLG) Score | The SMSLG scale integrated 3 skin features: skin wrinkling, adherence to underlying neck structures (bone and muscle), and redundancy (horizontal and vertical folds) assessed by the investigator using a 4-point scale where: 1=none, 2=mild, 3=moderate and 4=severe. A negative change from baseline indicated improvement. | Baseline (Day 0) to Week 58 | 
| Mean Change From Baseline to Final Study Visit in Jawline Definition, Based on Independent Reviewer Assessment Using the ALJDS and Photographic Images | The independent reviewer used photographic images collected at the time of the participant's live visit and the ALJDS to assess of loss of jawline definition using a 5-point scale where: 0=none, 1=mild, 2=moderate, 3=severe, 4=extreme. A negative change from baseline indicates improvement. | Baseline (Day 0) to Week 58 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lower Face Contouring