Steve Yoelin, MD, a Newport Beach, Calif.-based board-certified ophthalmologist with over two decades of experience, recently spearheaded a clinical trial for DelNova’s ReViVox®, which targets adverse effects of botulinum neurotoxins. Below, Dr. Yoelin discusses the trial’s proof-of-concept findings, demonstrating that ReViVox can reverse muscle weakness induced by neurotoxin treatments, potentially alleviating issues like eyelid ptosis and brow ptosis. Don’t miss out.

PSP: Can you please share more details about the first-in-human clinical trial for DelNova’s ReViVox and the specific adverse events it has been shown to address when it comes to botulinum neurotoxin treatments?

Steve Yoelin, MD: Our clinical study was a pilot that intended to show proof of concept in a small cohort of volunteers. We investigated the short-term effects of the ReViVox active ingredient (study drug). We were able to demonstrate that subjects treated with the study drug, an anticholinesterase, regained muscle movement after Botox wrinkle reduction. From the study, we conclude that ReViVox can be used to reverse muscle weakness. Off-target muscle weakness is often the source of unwanted side effects, such as eyelid ptosis, brow ptosis, and misalignment, that can result from aesthetic neuromodulator procedures.

PSP: How do you see the introduction of a reversal agent like ReViVox impacting the field of medical aesthetics and the patient experience with neurotoxin treatments?

Yoelin: ReViVox will be a welcome addition to the injectors’ armamentarium since injectors can more confidently administer neurotoxins to achieve optimal results without a conservative approach. Additionally, patients will be at ease knowing that undesirable outcomes caused by aesthetic neuromodulator procedures can be reversed. 

The use of hyaluronidase in addressing undesirable hyaluronic acid filler outcomes can be considered analogous to the use of ReViVox in addressing undesirable toxin outcomes. There has never been a comparable product on the market for use with toxins.

PSP: Can you please discuss the safety and side effects of using ReViVox to reverse botulinum neurotoxins from your clinical trial results?

Yoelin: The active ingredient in ReViVox has been in commercial use for decades to reverse neuromuscular blockade in anesthesia. In contrast to use in anesthesia as an intravenous drug, ReViVox is administered locally to the afflicted muscle after an aesthetic neuromodulator procedure. Local administration, rather than systemic administration, facilitates efficacy at a lower dose and avoids the systemic side effects that are associated with the anticholinesterase drug class.

PSP: What are the potential benefits and applications of ReViVox for patients who have experienced adverse events from botulinum neurotoxins, and how could it improve their quality of life?

Yoelin: Undesirable outcomes following a beauty treatment are associated with high stress and avoidance of social and workplace interactions. The advent of a product that can resolve these types of poor outcomes will be a boon to the aesthetic use of neurotoxins and allow patients who would have otherwise experienced these types of poor outcomes to resume their normal activities without distress.

Yoelin: Eye drops are available to help manage eyelid ptosis, but they offer a short-term symptomatic treatment that can only be applied to the eyelid. These drugs stimulate Muller’s muscle and lift the lid temporarily, but the underlying problem of muscle weakness is not addressed and typically will require a less than ideal, frequent daily dosing regimen. The drops may help lift the eyelid in the case of blepharoptosis but are useless in addressing other adverse effects, such as brow ptosis or other misalignment issues. ReViVox would be the first product to reverse the direct action of muscle weakness that is induced by neurotoxins.