According to ClinicalTrials.gov, Revance has recently completed a trial of a Botox based gel. This gel has been used in several centers to treat Crow\'s Feet. One obvious benefit of delivering a botulinum toxin with a gel is that it can get into the areas to be treated without a needle. This is a huge boon for people that fear needles and would otherwise like to be treated. Another possible benefit is that a gel may enable large parts of the body to be treated for sweating without multiple injections.
It is not clear from reports that are presently available how the gel will be used. Based upon what is known, it is likely that a patient will need to visit a physician and be evaluated. Following the consultation, it is possible that they will have the gel applied and wait while it is absorbed. It is not likely that the company would develop an \"at home\" version of this because of the need to have the product applied to precise areas.
For the gel to be commercially viable, the pricing would need to be comparable to injections. Although patients will likely pay extra for the comfort of a gel, if it is too much more expensive, they may stick with the existing delivery platforms.
The Revance product is not likely to be a threat to the injectable market. In fact, some have made the argument that it will increase the injectable market for Botox, Dysport and Xeomin because patients who otherwise might not have been interested in these products will be treated with a gel and want to see what the injectable type of product can do. As with Dysport, I think that the more discussions there are about the safety and efficacy of these proteins, the better off and the more people will understand how much research goes into them. People still come in to dermatology and plastic surgery offices afraid of these molecules because they erroneously think they are \"Poison\". Having another safe and effective treatment available will likely increase public knowledge and bring patients to the plastic surgeons and dermatologists who have the skill to inject or apply them.
Kenneth Beer MD