{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:51:35Z","timestamp":1791496295015,"version":"4.3.4"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T00:00:00Z","timestamp":1733616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T00:00:00Z","timestamp":1733616000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Immunoresistance to botulinum neurotoxin A (BoNT\u2010A) due to neutralizing antibodies (NAbs) can lead to partial or complete secondary nonresponse (SNR), potentially limiting individuals' aesthetic and\/or medical therapeutic options in the short and\/or long term. Understanding factors directly or indirectly influencing BoNT\u2010A immunoresistance risk is crucial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This analysis explored patterns of latent risk factors (biological and behavioral) that may influence the risk of developing BoNT\u2010A immunoresistance among experienced aesthetic BoNT\u2010A recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Latent class analysis (LCA) was applied to survey data from 363 experienced BoNT\u2010A recipients from six Asia\u2010Pacific countries to identify distinct subgroups based on their patterns of risk factor or risk proxy variables. The five risk proxy variables used for modeling capture information on BoNT\u2010A treatments (treatment indications\/locations as proxies for dose), symptoms of declining efficacy, number of aesthetic treatments over the past 3\u2009years, and clinic and BoNT\u2010A formulation switching behaviors. These represent established risk factors and treatment\u2010seeking behaviors suggested to influence immunoresistance risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>LCA identified 3 distinct profiles of individuals, which we described based on the observed patterns of risk proxies as: \u201clower\u2010risk\u201d (55%), \u201cmoderate\u2010risk\u201d (39%), and \u201chigher\u2010risk\u201d (6%). Individuals in the \u201chigher\u2010risk\u201d profile reported higher BoNT\u2010A exposure, more symptoms of declining efficacy, and distinct patterns of knowledge and attitudes toward BoNT\u2010A immunoresistance that could account for their treatment\u2010seeking behaviors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study suggests that individual behaviors (the \u201chuman factor\u201d) have a notable influence on BoNT\u2010A immunoresistance risk. Gaining deeper insights into these factors could support more targeted and effective interventions to mitigate risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jocd.16686","type":"journal-article","created":{"date-parts":[[2024,12,8]],"date-time":"2024-12-08T09:49:22Z","timestamp":1733651362000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying Different Immunoresistance Risk Profiles Among Experienced Aesthetic Botulinum Neurotoxin A Recipients: A Latent Class Analysis"],"prefix":"10.1111","volume":"24","author":[{"given":"Fang\u2010Wen","family":"Tseng","sequence":"first","affiliation":[{"name":"Everbeaute Medical Aesthetics  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasanop","family":"Vachiramon","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Faculty of Medicine, Ramathibodi Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5183-5433","authenticated-orcid":false,"given":"Michael H.","family":"Gold","sequence":"additional","affiliation":[{"name":"Gold Skin Care Center  Nashville Tennessee USA"},{"name":"Tennessee Clinical Research Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana","family":"Pavicic","sequence":"additional","affiliation":[{"name":"Private Practice for Dermatology &amp; Aesthetics Dr. Tatjana Pavicic  Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clifton M.","family":"Tay","sequence":"additional","affiliation":[{"name":"Merz Aesthetics Asia Pacific  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3699-3716","authenticated-orcid":false,"given":"Gerard W.","family":"Toh","sequence":"additional","affiliation":[{"name":"Tech Observer Asia Pacific  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana M. K.","family":"Tan","sequence":"additional","affiliation":[{"name":"Advocates for Advancing Health  Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Je\u2010Young","family":"Park","sequence":"additional","affiliation":[{"name":"Apkoo\u2010Jung Oracle Dermatology Clinic  Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,12,8]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"International Society of Aesthetic Plastic Surgery\u201cISAPS International Survey on Aesthetic\/Cosmetic Procedures Performed in 2022.\u201d2023. Access Date: 25 Mar 2024 https:\/\/www.isaps.org\/media\/a0qfm4h3\/isaps\u2010global\u2010survey_2022.pdf."},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins11090491"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325-021-01882-9"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004407"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000005892"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins12080499"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/toxins7124855"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781118901731.iecrm0130"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004710"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-022-11395-2"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13034-021-00380-8"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2023.115150"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v036.i07"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.77.6.1121"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-385522-0.00005-6"}],"container-title":["Journal of Cosmetic Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.16686","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jocd.16686","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jocd.16686","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T21:44:41Z","timestamp":1791495881000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jocd.16686"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,8]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/jocd.16686"],"URL":"https:\/\/doi.org\/10.1111\/jocd.16686","archive":["Portico"],"relation":{},"ISSN":["1473-2130","1473-2165"],"issn-type":[{"value":"1473-2130","type":"print"},{"value":"1473-2165","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,8]]},"assertion":[{"value":"2024-09-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e16686"}}