Letybo vs Dysport, Xeomin, Daxxify and Jeuveau: Why the Comparison Tables Are Wrong
Reviewed for medical accuracy against our Medical Review Board · Last updated 2 September 2026
Part of Botox vs Other Brands
Letybo is the newest botulinum toxin approved in the US, and the obvious question is how it compares with the four it competes against. Every page answering that lines up the brands' success percentages in a table.
Those tables are worthless, and Letybo's own trial data is the clearest proof of why.
Letybo ran three trials of identical design and got 47%, 49% and 65%. Same drug, same protocol, same dose, same endpoint, an 18-point spread. If a product varies that much against itself, putting its number beside another brand's and drawing a conclusion is not a comparison. It is noise.
What is actually the same across all five
Start here, because most of the marketing rests on differences that are not there.
Letybo and Jeuveau are near-identical on paper. Both are botulinum toxin type A. Both are 900 kDa complexes. Both are approved for one thing, moderate to severe glabellar lines in adults. Both use exactly the same dose and map: 0.1 mL, 4 Units, into each of five sites, one in the procerus and two in each corrugator supercilii, for 20 Units total. Both instruct retreatment no more often than every three months.
Dysport, Xeomin and Daxxify differ in that each also holds medical approvals, so their labels carry doses for conditions like cervical dystonia and spasticity that have nothing to do with a frown line. For the glabella specifically, all five are doing the same job by the same mechanism: cleaving SNAP-25 so the nerve terminal stops releasing acetylcholine.
And every one of the five states that its units cannot be converted into any other product's units, because potency is set by an assay specific to each manufacturer. That single fact invalidates most price comparisons you will be shown. We set the labelled doses out together on the unit conversion page.
The 18-point spread that breaks every comparison table
Letybo's approval rests on three trials, BLESS I, BLESS II and BLESS III, which the label describes as being of identical design. Together they enrolled 1,276 people, randomised 3 to 1, which is nearly double the size of Jeuveau's programme.
| Trial | Letybo | Placebo |
|---|---|---|
| BLESS I | 246/528 (47%) | 0/175 (0%) |
| BLESS II | 78/160 (49%) | 1/53 (2%) |
| BLESS III | 172/266 (65%) | 0/89 (0%) |
Read those three rows again. 47%, 49%, 65%. Identical protocol, identical dose, identical endpoint, same drug. The only things that changed were the sites and the people who walked through the door.
Now consider what a typical comparison page does. It takes Jeuveau's 68% from one trial and Letybo's 47% from another and concludes Jeuveau is better. But Letybo's own range covers 18 points, and had that page picked BLESS III it would have printed 65% and concluded almost nothing separates them.
No head-to-head trial exists between any of these five products. Not one. Every number you will see compared was generated in a separate study, with different patients, at different sites, in different years. That is why we will not rank them on percentages, here or anywhere.
One technical point, because it would be an easy and wrong thing to claim: Letybo's endpoint is worded more strictly than Jeuveau's, requiring a score of 0 or 1 and at least a 2-point improvement, where Jeuveau's requires a 2-grade improvement. On a 4-point scale with entry at moderate or severe, a 2-grade improvement necessarily lands you at 0 or 1 anyway. So the two endpoints are effectively equivalent, and the wording is not the explanation for the gap.
The headache numbers invert when you read the placebo column
Headache is the most-cited side effect for this class, and the two newest brands look wildly different on it until you read the second column.
| Product | Headache on drug | Headache on placebo | Attributable |
|---|---|---|---|
| Jeuveau | 57/492 (12%) | 21/162 (13%) | None |
| Letybo | 17/911 (2%) | 2/310 (1%) | About 1 point |
Raw, Jeuveau's 12% looks six times worse than Letybo's 2%. Placebo-adjusted, Jeuveau's trial attributes no headache to the drug at all, because the placebo group reported slightly more, while Letybo's attributes roughly one percentage point.
Neither product shows a meaningful headache signal. But a comparison table printing "12% vs 2%" would tell you the opposite of what the data says. This is the same trap as the efficacy percentages, in a different column.
Letybo's other reported reactions were all under 1%: brow ptosis 3 of 911, eyelid ptosis 3 of 911, and blepharospasm 2 of 911, each against zero on placebo. Those are small numbers but they are the ones attributable to the drug.
Where they genuinely differ
Having thrown out the percentage comparisons, here is what does separate them, from the labels.
| Letybo | Jeuveau | Dysport, Xeomin, Daxxify | |
|---|---|---|---|
| Approved areas | Glabellar lines only | Glabellar lines only | Glabellar lines plus medical indications |
| Trial programme size | 1,276 across 3 trials | 654 across 2 trials | Varies |
| Vial sizes | 50 Units and 100 Units | 100 Units only | Varies |
| Labelled duration for glabellar lines | None stated | None stated | Dysport states "up to four months". Xeomin and Daxxify state none |
| Manufacturer | Hugel | Evolus | Ipsen, Merz, Revance |
Two of those rows are worth dwelling on.
The vial sizes matter far more than they look, and the reason is a rule most people never see. Both labels state that a vial is single-dose: after reconstitution it may be used for one injection session and one patient only, and any remaining solution is discarded immediately. A vial is not shared between patients.
A glabellar treatment is 20 Units. So a clinic opening a 100 Unit vial discards 80 Units for that patient. With Letybo's 50 Unit vial it discards 30. Jeuveau is supplied only as 100 Units, so it has no smaller option. That difference in waste is real money per patient, and it is one of the few structural reasons a clinic's price for one brand can sit genuinely below another's rather than as a promotion.
Only Dysport, of these, states a duration for glabellar lines, at up to four months. Xeomin, Daxxify, Letybo and Jeuveau state none. That is worth knowing given Daxxify is marketed on longevity. We go through all six labels on how long Jeuveau lasts.
One further difference, and it is a warnings difference rather than a marketing one. Letybo's label carries two categories of caution that Jeuveau's does not list in the same way: cardiovascular adverse reactions, covering reports of arrhythmia and myocardial infarction following botulinum toxin administration, some fatal; and ophthalmic adverse reactions, covering dry eye, reduced tear production, reduced blinking and corneal disorders in patients treated for glabellar lines. These are class observations rather than Letybo-specific findings, but they appear on that label and are worth reading.
So how do you choose
Not on percentages, for every reason above. Here is what actually narrows it.
- Is your area approved for the product being offered? Letybo and Jeuveau cover the glabella and nothing else. If you want forehead or crow's feet with a labelled dose, that is Botox. See frown lines and the glabella.
- Have you used one before and how did it go? Your own history with a specific product is better evidence than any trial, because it is a head-to-head test on the only patient who matters.
- What is the total price for your area? Not the per-unit rate, which is not comparable between brands because the assays differ.
- Does your injector use it often? Familiarity with a product's spread and behaviour is worth more than a two-point difference in a trial you cannot compare anyway.
- Do you need a medical indication? Only Dysport, Xeomin and Daxxify hold any, among these.
For each product in depth, see the Letybo guide, Jeuveau, Dysport, Xeomin and Daxxify. For Letybo against Botox specifically, see Botox vs Letybo.
Frequently asked questions
Is Letybo better than Dysport, Xeomin, Daxxify or Jeuveau?
Is Letybo the same as Jeuveau?
Does Letybo cause fewer headaches than Jeuveau?
How many people were in the Letybo trials?
Why does Letybo come in a 50 unit vial?
Which of these lasts longest?
Sources
Every figure on this page was read from the documents below rather than from a clinic or a manufacturer's marketing. They open in a new tab so you can check any claim here against its source.
- LETYBO (letibotulinumtoxinA-wlbg) for injection, full prescribing information, US National Library of Medicine, DailyMed
- JEUVEAU (prabotulinumtoxinA-xvfs) for injection, full prescribing information, US National Library of Medicine, DailyMed
- FDA-approved botulinum toxin products, US Food and Drug Administration
Know the count before the quote. The unit count is half the bill, and a low per-unit rate recovered by a high unit count is the commonest way a deal is not one. How to tell.
Deciding which area, not how many units? Botox by facial area covers what each zone actually achieves, which four are FDA approved, and the things Botox cannot fix at all.
