Evidence map›Paper›PMID 41673282›Full record

ArticleAesthetic plastic surgery2026

AI-Enabled Surveillance and Modelling for Counterfeit Botulinum Toxin A: Risk Projection, Patient Safety, and Systemic Reform of Pharmacovigilance.

Eqram Rahman, Parinitha Rao, Karim Sayed, Alain Michon, Nanze Yu, Sotirios Ioannidis, Patricia E Garcia, Woffles T L Wu, Jean D A Carruthers, William Richard Webb

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Article in Aesthetic plastic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Eqram RahmanResearch and Innovation Hub, Innovation Aesthetics, London, WC2H 9JQ, UK. Eqram.rahman@gmail.com.ORCID 0000-0002-8443-8338
Parinitha RaoThe Skin Address, Aesthetic Dermatology Practice, Bangalore, India.
Karim SayedNomi Oslo, Oslo, Norway.
Alain MichonProject Skin MD Ottawa, Ottawa, ON, Canada.
Nanze YuDepartment of Plastic Surgery, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Sotirios IoannidisPlastic Surgery Clinic, 546 21, Thessaloniki, Greece.
Patricia E GarciaPrivate Practice in Dermatology, Puerto Vallarta, Mexico.
Woffles T L WuWoffles Wu Aesthetic Surgery and Laser Centre 1, Camden Medical Centre, Orchard Boulevard Suite 09-02, Singapore, Singapore.
Jean D A CarruthersDepartment of Ophthalmology, University of British Columbia, Vancouver, BC, Canada.
William Richard WebbResearch and Innovation Hub, Innovation Aesthetics, London, WC2H 9JQ, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCounterfeit Botulinum Toxin A (BoNT-A) poses a growing global threat, particularly in aesthetic medicine where regulatory oversight is minimal and underreporting is widespread. Traditional pharmacovigilance systems such as FAERS and EudraVigilance fail to detect early counterfeit exposure due to reliance on delayed, structured reporting. As counterfeit incidents increase across multiple regions, a proactive, data-driven approach is urgently needed.

objectivesThis study aimed to develop and validate an AI-enabled surveillance system capable of detecting counterfeit BoNT-A exposures in real time, projecting regional risk through 2035, and reforming pharmacovigilance in deregulated aesthetic markets.

methodsOver 2.5 million data points from 2015 to 2025 were analyzed, integrating adverse event databases, customs seizure records, patient forums, social media platforms, and global market data. Natural language processing models (BioBERT, RoBERTa, XLM-R) processed multilingual narratives. Counterfeit exposure probabilities were derived using probabilistic inference and anomaly detection. Forecasting models (ARIMA, Prophet, GNNs) projected long-term risk, and robustness was assessed through simulated crises.

resultsThe AI system detected counterfeit exposure signals an average of 31 days before regulatory alerts, with over 86% spatial match accuracy. Platforms like RealSelf and Reddit showed >91% concordance with known adverse event profiles. Forecasts project a global counterfeit exposure increase of 4.9% annually through 2035, with regional peaks in Turkey (risk score 0.76), Brazil, and India. South America is expected to exceed counterfeit-related AEs annually by 2035, a 70% rise. The model maintained >87% accuracy in stress simulations and achieved a mean F1-score of 88.7% across six languages.

conclusionsThis study demonstrates the feasibility and urgency of AI-driven pharmacovigilance in aesthetic medicine. The BoNT-A Risk Burden Index offers a predictive, patient-centred tool to detect and mitigate counterfeit exposures before widespread harm occurs. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Indexed as

Adverse Drug Reaction Reporting SystemsArtificial IntelligenceBotulinum Toxins, Type ACounterfeit DrugsPharmacovigilanceHumansPatient SafetyRisk AssessmentBotulinum Toxins, Type ACounterfeit DrugsAdverse eventsAesthetic medicineArtificial intelligenceCounterfeit botulinum toxin APharmacovigilanceRisk forecastingSocial media surveillance

Identifiers

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.