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Ask the Expert

XEOMIN® is made through a unique precision manufacturing process that isolates the therapeutic component of the molecule and removes the accessory proteins that don’t play an active role in treatment. XEOMIN® (incobotulinumtoxinA) is a new generation, pure botulinum toxin, free from impurities*.

DR. KATE GOLDIE
DR. KATE GOLDIE
Aesthetic Physician, UK

Dr. Goldie has been an aesthetic physician for 10 years and is the Medical Director of European Medical Aesthetics training, one of European largest training companies. Through Medics Direct, the UK training arm of this organization she has overseen the training of over 4000 medical professionals. She regularly lectures globally and has taught medical aesthetics in 30 countries covering a wide range of basic and advanced techniques with a special interest in applied anatomy. Medical director of the Advanced Rejuvenation Clinic, Dr. Goldie has private practices in London’s Harley Street and Henley on Thames. She is a member of the British College of Aesthetic Medicine, the chairperson of the UK Aesthetic Medicine Expert Group with whom she co-authored the UK expert consensus on prevention and management complications. She is also a board member of The Prime Journal of Aesthetic Medicine, and was recently voted as one of the top three aesthetic doctors in the UK for the past three years by peers at the British Aesthetic Medicine Awards London in December 2014.

Dr Goldie feels that, like her, Merz places a high value on the scientific validation of treatments and producing innovative, effective products. ‘These are my own aims’, she reveals, ‘to use convenient, effective products made with natural ingredients that are scientifically validated to produce the best possible results’.

How do you discuss the various botulinum toxin product choices with your patients?

I help my patients to understand the differences between the formulations available – some botulinum toxins contain complexing proteins while XEOMIN® does not. I explain that the purification process of XEOMIN® removes the complexing proteins which are not required for the therapeutic effect. Therefore, the only clostridial protein XEOMIN® contains is the active neurotoxin needed to produce the aesthetic outcome.

Do you inform your patients that XEOMIN® is free from complexing proteins?

I do explain that XEOMIN® is pure neurotoxin and does not contain any complexing proteins. I make sure my patients understand this and the rationale behind choosing a product that is free from complexing proteins.

Is it important that patients understand the benefits of a formulation of botulinum toxin that is free from complexing proteins?

Most of medicine and aesthetics is about the physician–patient relationship and it is my job to help patients understand my thinking in order to help them make the best decisions. Patients need to understand why it is important to use a formulation free from complexing proteins, so I must explain it in a way that patients understand. They are then equipped to make the decision themselves because they understand my rationale. I usually explain some of the basic science to patients. This is important information for patients – they are introducing something into their body so they need to know exactly what it is and why I recommend a formulation that has less excess protein with an unknown or no function.

How can these complications be avoided?

Complete facial analysis of anatomical structure and an individual’s use of their anatomy is vital to avoiding complications. Combining accurate, careful injection technique with a thorough knowledge of appropriate dosing can prevent most of the complications of the upper face.


DR. JÜRGEN FREVERT
DR. JÜRGEN FREVERT
PhD, Biochemist

“I'm proud that we succeeded in developing a pure product”

Dr Jürgen Frevert could be described as the father of XEOMIN®. He first heard of the toxin more than 30 years ago, when, as a post-doctoral researcher, he was tasked with purifying botulinum toxin type A.

XEOMIN® IS PART OF A LIFETIME OF BOTULINUM TOXIN RESEARCH

'I'm proud that we succeeded in developing a highly purified neurotoxin, the only product currently on the market that is free of other bacterial proteins and which is stable at room temperature', Dr Frevert enthuses.

'As a basic scientist, a biochemist, it is very satisfying to have developed a product, with my own hands, that has been used in over 1.6 million patients in numerous indications. And it is a high-quality product - of all the patients treated to date, none have developed neutralising antibodies or have become secondary non-responders, allowing patients to benefit from repeat treatments.

Not only is the neurotoxin the only bacterial protein present in each vial of XEOMIN®, the manufacturing process is so exquisitely controlled that the purified neurotoxin does not lose any activity. This means that, whilst having the lowest amount of neurotoxin in the vial, XEOMIN® has the highest specific potency compared with two other commercially available botulinum toxin products' 1.

'I knew that complexing proteins could stimulate the immune system to produce antibodies that neutralise the neurotoxin' Dr Frevert reveals. 'I wanted to produce a new formulation of the neurotoxin without the complexing proteins that other available formulations contain. Then patients only get what they need, just the highly purified neurotoxin, and therefore the risk of antibody formation is minimised'.

Reference:
Frevert J. Drugs R D 2010;10:67–73.

*Impurities refer to the presence of complexing proteins, inactive neurotoxin, flagellin and bacterial DNA contaminants1.

1. Park JY, et al. Neurotoxin impurities: A Review of threats to Efficacy. Plast Reconstr Surg Glob Open. 2020;8(1):e2627


DR. MICHAEL PFEIL
DR. MICHAEL PFEIL
PhD, Site Head of Merz Pharmaceuticals’ state-of-the-art production facility at Dessau, Germany

Michael Pfeil has been involved in the manufacture of XEOMIN® from day 1.
‘I was involved from the very beginning, in every decision: how to grow the bacteria and how to purify the toxin, which technologies and processes to use, how to organise it all. Now I’m proud to look out of my office window and see how far we’ve come’.

EACH VIAL CONTAINS OUR ENTHUSIASM AND SINGLE-MINDED COMMITMENT TO QUALITY

‘I was involved from the very beginning, in every decision: how to grow the bacteria and how to purify the toxin, which technologies and processes to use, how to organise it all. Now I’m proud to look out of my office window and see how far we've come’.

Setting XEOMIN® apart is the complex and labour-intensive manufacturing process that removes the complexing proteins to make a highly purified product. From the customised equipment specifically designed for the site and this type of manufacturing to the safety and environmental protection standards that are higher than regulations require, Merz has demonstrated their uncompromising attitude to quality.

From first to last, Dr Pfeil and his dedicated team are committed to producing a high-quality product, following their self-imposed standards, as they believe the patient deserves nothing less. The site at Dessau was designed specifically for the manufacture of a highly purified product and every stage of the production process can be seen through the glass walls that surround the manufacturing area.

Far from being hidden, the state-of-the-art technology and manufacturing process, of which Dr Pfeil and his team are understandably proud, are on display for all to see.



 

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