Bill Andriopoulos, PhD: Inside the PEARL Technology and Phase 3 Results of Relfydess

In this exclusive interview with Dermatology Times, Bill Andriopoulos, PhD, Head of Global Medical Affairs at Galderma, outlines the scientific and clinical developments surrounding Relfydess (relabotulinumtoxinA), a next-generation neuromodulator highlighted at the TOXINS 2026 International Conference in Madrid, Spain. With his extensive leadership experience across regions and aesthetic portfolios, Andriopoulos emphasized renewed innovation in a category that has seen limited manufacturing evolution over the past 3 decades.

“There has been a historic lack of innovation in this time, meaning patients and health care professionals have had to settle for traditional manufacturing and reconstitution processes that can limit performance, ease of use, and reliability,” he said.

Central to Andriopoulos’ discussion is PEARL Technology, a proprietary, multi-step purification platform underpinning Relfydess. PEARL stands for precipitation, free extraction, and activity-preserving refined liquid, Andriopoulos noted. Unlike traditional botulinum toxin products supplied as lyophilized powders requiring reconstitution, Relfydess is the first ready-to-use liquid neuromodulator designed to maintain the toxin in liquid form throughout manufacturing. The process removes complexing proteins and impurities while preserving molecular integrity and enzymatic activity, aiming to optimize both purity and biologic function. The liquid format also supports volumetric dosing and workflow efficiency by eliminating reconstitution variability.

Clinical performance data were drawn from the phase 3 READY program, which included more than 1,900 participants across 4 trials. Pooled post hoc subgroup analyses presented in poster sessions demonstrated onset of action as early as day 1, with sustained efficacy and high responder rates maintained through 6 months for both glabellar lines and lateral canthal lines. Outcomes were consistent across patients with moderate and severe baseline wrinkle severity. In addition to aesthetic endpoints, patient-reported outcomes indicated improvements in psychological well-being, reflecting the broader impact of facial aesthetic treatments.

Safety and pharmacologic behavior were further explored in a preclinical in vivo head-to-head model comparing Relfydess with onabotulinumtoxinA (Botox) using clinically relevant dose ratios. Both agents produced expected muscle inhibition, with similarly limited diffusion to adjacent muscles. These findings align with phase 3 data demonstrating a favorable tolerability profile, low eyelid ptosis rates comparable to established neuromodulators, and no evidence of remote toxin spread.