ATX-101 for reduction of submental fat: A phase III randomized controlled trial

Shannon Humphrey, Jonathan M Sykes, Jonathan Kantor, Vince Bertucci, Patricia Walker, Daniel R. Lee, Paul F. Lizzul, Todd M. Gross, Frederick C. Beddingfield

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


Background ATX-101, an injectable form of deoxycholic acid, causes adipocytolysis when injected subcutaneously into fat. Objective We sought to evaluate the efficacy and safety of ATX-101. Methods In this phase III trial (REFINE-2), adults dissatisfied with their moderate or severe submental fat (SMF) were randomized to ATX-101 or placebo. Coprimary end points, evaluated at 12 weeks after last treatment, were composite improvements of 1 or more grades and 2 or more grades in SMF observed on both the validated Clinician- and Patient-Reported SMF Rating Scales. Other end points included magnetic resonance imaging–based assessment of submental volume, assessment of psychological impact of SMF, and additional patient-reported outcomes. Results Among those treated with ATX-101 or placebo (n = 258/treatment group), 66.5% versus 22.2%, respectively, achieved a composite improvement of 1 or more grades (Mantel-Haenszel risk ratio 2.98; 95% confidence interval 2.31-3.85) and 18.6% versus 3.0% achieved a composite improvement of 2 or more grades in SMF (Mantel-Haenszel risk ratio 6.27; 95% confidence interval 2.91-13.52; P < .001 for both). Those treated with ATX-101 were more likely to achieve submental volume reduction confirmed by magnetic resonance imaging, greater reduction in psychological impact of SMF, and satisfaction with treatment (P < .001 for all). Overall, 85.7% of adverse events in the ATX-101 group and 76.9% in the placebo group were localized to the injection site. Limitations Follow-up was limited to 44 weeks. Conclusion ATX-101 is an alternative treatment for SMF reduction.

Original languageEnglish (US)
Pages (from-to)788-797.e7
JournalJournal of the American Academy of Dermatology
Issue number4
StatePublished - Oct 1 2016


  • aesthetics
  • ATX-101
  • contouring
  • deoxycholic acid
  • efficacy
  • injectable
  • minimally invasive
  • nonsurgical
  • safety
  • submental fat

ASJC Scopus subject areas

  • Dermatology


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