What This Study Is About

This study compared six FDA-approved injectable neurotoxins—used to smooth frown lines between the eyebrows (glabellar lines). The products studied were BOTOX®, Dysport®, XEOMIN®, DAXXIFY®, Jeuveau®, and Letybo®.

Why It Matters

All six products work the same basic way: They temporarily relax the muscles that cause frown lines. However, they are not identical. Each product is manufactured differently, and a “unit” of one brand is not the same as a “unit” of another.

Until now, doctors have mostly relied on rough conversion numbers (like “use 2.5 times as many units of Dysport® as BOTOX®”) to switch patients between products. This study shows that those simple ratios are incomplete because the products behave differently over time.

How They Compared Them

The researchers built a sophisticated computer simulation using data from 49 clinical trials. They created 10,000 virtual patients for each product to see how the treatments perform from injection day through 24 weeks—including how fast they kick in, how strong the peak effect is, and how long they last.

Key Findings

How long each product lasts (on average):

Product	Average Duration
Jeuveau®	14.5 weeks
DAXXIFY®	13.9 weeks
BOTOX®	12.0 weeks
XEOMIN®	11.8 weeks
Letybo®	11.0 weeks
Dysport®	10.6 weeks

Bang for your buck (effect per unit): Jeuveau® and DAXXIFY® delivered the most clinical effect per unit injected, followed by BOTOX®. Dysport® required the most units to achieve the same overall result.

Conversion ratios change over time: A dose of Dysport® that matches BOTOX® at four weeks may no longer match it by week 12, because the effect of Dysport® fades faster. The study found this “drift” was as large as 35% for Dysport® and 27% for Letybo®. In contrast, DAXXIFY® and Jeuveau® maintained their effects more consistently over time.

What This Means for You as a Patient

Not all neurotoxins are interchangeable. If your provider switches you from one brand to another using a simple unit conversion, your results could vary—you might notice the effect wearing off sooner or feeling different.
Longer-lasting options exist. If you find yourself needing touch-ups before your next scheduled appointment, products like DAXXIFY® or Jeuveau® may offer longer-lasting results, based on this data.
Your provider’s expertise matters. The best product for you depends on your anatomy, treatment goals, and how your body responds. This study reinforces the importance of individualized treatment planning—rather than a one-size-fits-all approach—for achieving the best outcomes.

Take-Home Message

Until now, differences in neurotoxins have been anecdotal and marketing-driven. “X” neurotoxin is the best because it is cleaner. “Y” neurotoxin is best because it is more precise. Thankfully, this study begins to contribute to the real scientific data comparing the different products and supports our preference for using Jeuveau® in most cases.