Botulinum neurotoxin type A1 – RTP004 peptide complex (DAXI)

The Botulinum neurotoxin type A1 – RTP004 peptide complex, commercially known as daxibotulinumtoxinA-lanm (DAXXIFY), is a therapeutic neuromodulator consisting of the 150 kDa botulinum neurotoxin type A1 (BoNT/A1) core protein non-covalently associated with a proprietary 35-amino acid synthetic peptide, RTP004 [1, 12]. RTP004 is a highly positively charged cell-penetrating peptide (CPP) that serves as a stabilizing excipient, replacing the human serum albumin (HSA) typically found in other botulinum toxin formulations [2, 6]. This peptide enhances the toxin's affinity for the negatively charged neuronal membrane, facilitating increased cellular uptake and subsequent cleavage of the synaptosomal-associated protein 25 (SNAP-25) [3, 4]. By cleaving SNAP-25, the complex prevents the formation of the SNARE complex required for acetylcholine release at the neuromuscular junction, leading to temporary muscle paralysis [10, 11]. The primary clinical advantage of this complex is its extended duration of action, which has been shown to last approximately six months in many patients [4, 12]. It is FDA-approved for the treatment of glabellar lines and cervical dystonia, with ongoing research into other neuromuscular and pain-related indications [6, 11].

Other names

DaxibotulinumtoxinA-lanmDAXXIFYRT002RTT150-RTP004 complexRevance peptide-toxin complex

The RTP004 peptide non-covalently binds to BoNT/A1, enhancing its stability and neuronal membrane binding; the toxin then enters neurons and cleaves SNAP-25 to inhibit acetylcholine release [1, 3, 12].