STYLAGE® M Lidocaine is a hyaluronic acid injectable gel CE (conformité européenne)-marketed since 2009 . It is indicated for the outline of the lips and/or for lips augmentation in lips mucosa. It is also indicated to fill skin depressions on the face. Lidocaine is intended to reduce the pain associated with the injection. The aim of SMILE study is to demonstrate that STYLAGE® M Lidocaine is non-inferior to an active comparator that has shown its effectiveness in lips' volume augmentation and restoration in improving the aesthetic appearance of the lips evaluated by subjects. In this study, 92 healthy volunteers between 18 and 65 years old, who expressed the wish for augmentation or restoration of the volume of the lips and/or lips' outline redefinition, confirmed by investigators at inclusion, who have given his/her informed consent and who met all the eligibility criteria, will be enrolled. Subjects will randomly receive STYLAGE® M Lidocaïne or the active comparator (ratio 1:1) injection in the lips at first visit on Day 0. At second visit, one month after Day 0, an optional touch-up injection could be performed according to subject's and investigator's opinions and if the subject is still eligible. Subjects will have a total of 6 visits over a 12 months follow-up period and a screening visit prior to first injection. Proportion of subjects having a global aesthetic improvement of their lips (blinded self-evaluation), 3 months after treatment initiation will be assessed and compared between the two groups. This will also be done during the other visits (1, 6, 9 and 12 months after treatment initiation). Global aesthetic improvement according to blinded independent evaluator, subjects' satisfaction, pain during injection and safety parameters will also be assessed during the study period.
This is a prospective, double blinded, randomized, active controlled, multicenter study. Subjects are randomly assigned to receive either STYLAGE® M Lidocaine or the active comparator (ratio 1:1). Ninety two subjects between 18 and 65 years old who expressed the wish for augmentation or restoration of the volume of the lips and/or lips' outline redefinition, confirmed by investigators at inclusion, who have given his/her informed consent and who met all the eligibility criteria (especially according to the instructions for use of the devices), will be include. After a screening visit for selection, each subject will be followed for 12 months after 1st injection at Visit 1 (on Day 0). Five follow-up visits are scheduled 1, 3, 6, 9 and 12 months after initial injection (Visits 2 to 6). At 1 month (Visit 2), an optional touch-up injection may be done (if needed). The primary objective is to demonstrate non-inferiority of STYLAGE® M Lidocaine versus the active comparator in improving the aesthetic appearance of the lips. The comparison of effectiveness between the devices will be done according to proportion of subjects having an improvement on the 5-point Global Aesthetic Improvement Scale (GAIS) evaluated by the blinded subject on the lips (after mirror self-examination), 3 months after treatment initiation (V1). Improvement according to GAIS corresponds to one of these three categories: "Very much improved", "Much improved" or "Improved". Secondary objectives include subjects' self-evaluation of their lips according to GAIS, at 1, 6, 9 and 12 months after treatment initiation. Global aesthetic improvement of the lips according to blinded independent evaluator, subjects' satisfaction, subjects' self-evaluation of pain during injection will also be measured and collected at each visit during the whole study period. Study products tolerance will be assessed by collection of injection site reactions after each injection session, and adverse events throughout the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
92
Injection in the lips
Injection in the lips
Eurofins Dermscan Pharmascan
Villeurbanne, France
Eurofins Dermscan Poland
Gdansk, Poland
Subject self-assessed global aesthetic evolution of the lips
Proportion of subjects having a positive aesthetic evolution on the 5-point Global Aesthetic Improvement Scale (GAIS) evaluated by the subject on the lips (after mirror self-examination), 3 months after treatment initiation (V1). Positive aesthetic evolution according to Global Aesthetic Improvement Scale (GAIS) corresponds to one of these three categories: "Very much improved", "Much improved" or "Improved". The 5-point GAIS contains the following categories: "Very much improved", "Much improved", "Improved", "No change" and "Worse".
Time frame: Month 3
Subject self-assessed global aesthetic evolution of the lips
Proportion of subjects having a positive aesthetic evolution of the lips at 1, 6, 9 and 12 months, after treatment initiation, as assessed by the subject (after mirror self-examination) using the 5-point Global Aesthetic Improvement Scale (GAIS). Positive aesthetic evolution according to Global Aesthetic Improvement Scale (GAIS) corresponds to one of these three categories: "Very much improved", "Much improved" or "Improved". The 5-point GAIS contains the following categories: "Very much improved", "Much improved", "Improved", "No change" and "Worse".
Time frame: Month 1, Month 6, Month 9, Month 12
Investigator's assessment of global aesthetic evolution of the lips
Proportion of subjects having a positive aesthetic evolution of the lips at 1, 3, 6, 9 and 12 months, after treatment initiation, as assessed in live by a blinded independent evaluator using the 5-point Global Aesthetic Improvement Scale (GAIS). Positive aesthetic evolution according to Global Aesthetic Improvement Scale (GAIS) corresponds to one of these three categories: "Very much improved", "Much improved" or "Improved". The 5-point GAIS contains the following categories: "Very much improved", "Much improved", "Improved", "No change" and "Worse".
Time frame: Month 1, Month 3, Month 6, Month 9, Month 12
Lips' surface aspect
Proportion of subjects having a positive aesthetic evolution of the surface aspect of the lips at 1, 3, 6, 9 and 12 months as assessed in live by a blinded independent evaluator using a 5-point questionnaire. For each items of the questionnaire, improvement corresponds to one of these two categories: "Much improved" or "Improved". For each of the 5 items of the questionnaire, one of the following answer is selected: "Much improved", "Improved", "No change", "Worsened", "Very worsened"
Time frame: Month 1, Month 3, Month 6, Month 9, Month 12
Evolution of subject's satisfaction
Mean changes in subject's satisfaction scores from baseline to 1, 3, 6, 9 and 12 months using the FACE-Q© "satisfaction with lips" questionnaire. The FACE-Q© is a patient-reported outcome (PRO) measure of outcomes of aesthetic facial procedures and products from the patient's perspective. The FACE-Q© "satisfaction with lips" is a scale that measures the appearance of the lips with items that ask about size, shape and fullness, as well as how their lips suit their face and how the lips look when smiling. For each of the 10 items, one of the following answer is selected: "Very dissatisfied", "Somewhat dissatisfied", "Somewhat satisfied", "Very satisfied". Patient responses to each item are graded on a four-point scale and then converted to a score on a scale from 0 (worst) to 100 (best). A higher score means greater satisfaction.
Time frame: Month 1, Month 3, Month 6, Month 9, Month 12
Pain during injection
Mean pain scores during injection assessed by the subjects using a 11-point numeric rating scale (0 to 10) at V1 (D0) and V2 (M1) if applicable.
Time frame: Day 0, Month 1
Report of adverse events
Product tolerance will be assessed by collection of Injection Site Reactions (ISRs) after each injection session, and Adverse Events (AEs) throughout the study. AEs will be summarized by MedDRA System Organ Class and Preferred Term, and will be tabulated by severity, causality, action taken and outcome, using descriptive statistics.
Time frame: Day 0, Month 1, Month 3, Month 6, Month 9, Month 12
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