Efficacy and safety of injectable deoxycholic acid for submental fat reduction: a systematic review and meta-analysis of randomized controlled trials

Expert Rev Clin Pharmacol. 2021 Mar;14(3):383-397. doi: 10.1080/17512433.2021.1884070. Epub 2021 Feb 13.


Objective: To investigate the efficacy and safety of deoxycholic acid (DOC) for SMF reduction.Methods: We conducted a systematic review and meta-analysis of randomized controlled trials. We searched PubMed/MEDLINE, EMBASE, and Cochrane databases until June 2020. Efficacy outcomes: Clinician-Reported Submental Fat Rating Scale; Patient-Reported Submental Fat Rating Scale; Subject Self-Rating Scale; SMF reduction measured using caliper and resonance magnetic imaging; Early therapeutic success. Safety outcomes: Withdrawals due to adverse events (AEs), Rates of AEs, Skin laxity.Results: Five studies were included, comprising 1,838 participants. DOC (1 or 2 mg/cm2) had greater improvement in all efficacy measures compared to placebo. No differences were seen between both doses of DOC. Withdrawals due to AEs were low with 1 and 2 mg/cm2 of DOC (6.8% vs. 9.9%, respectively), and there was no difference between the two doses (p = 0.22). AEs were usually associated with the injection site, were predominantly transient, and commonly resolved within the treatment session interval. Injection site pain, hematoma, anesthesia/numbness, erythema, and swelling/edema were the most common AEs. There was no difference in their prevalence between both doses of DOC.Conclusions: DOC is effective and safe for SMF reduction with no differences between doses of 1 and 2 mg/cm2.

Keywords: ATX-101; deoxycholate; deoxycholic acid; efficacy; safety; submental fat.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Chin
  • Cholagogues and Choleretics / administration & dosage
  • Cholagogues and Choleretics / adverse effects
  • Cosmetic Techniques*
  • Deoxycholic Acid / administration & dosage*
  • Deoxycholic Acid / adverse effects
  • Humans
  • Injections, Subcutaneous
  • Magnetic Resonance Imaging
  • Neck
  • Randomized Controlled Trials as Topic
  • Subcutaneous Fat / drug effects*


  • Cholagogues and Choleretics
  • Deoxycholic Acid