Botulinum neurotoxin type A-ABO (Dysport): clinical indications and practice guide

The key points to remember about abobotulinumtoxinA are as follows: BoNTA-ABO (abobotulinumtoxinA [Dysport]; Medicis Aesthetics, Scottsdale, AZ) and BoNTA-ONA (onabotulinumtoxin A [Botox Cosmetic]; Allergan, Irvine, CA) are both derivatives of botulinum toxin A produced from different strains of the bacterium Clostridium botulinum through proprietary manufacturing processes, and both are approved by the US Food and Drug Administration (FDA). BoNTA-ABO and BoNTA-ONA, which are both type A botulinum toxins, should be further differentiated from Myobloc (Solstice Neurosciences, San Francisco, CA), which is the only FDA-approved type B botulinum toxin. BoNTA-ABO, as with other derivatives of botulinum toxin, produces a chemodenervation of the muscle by preventing the release and binding of acetylcholine at the neuromuscular endplate. The paralytic effect of BoNTA-ABO, as with other derivatives of botulinum toxin, produces a relaxation of the underlying muscle with the associated benefit of reducing dynamic rhytids of the overlying skin. BoNTA-ABO units are not interchangeable with BoNTA-ONA units. An understanding of the proper dosing and familiarity with the use of either botulinum toxin in aesthetic applications is required to produce results that are both safe and consistent. Spread of the toxin is dependent on solution volume and injection technique (physically pushing the toxin from the area of injection). Diffusion of the toxin is largely dependent on toxin dose and receptor concentration; unbound toxin moves down a concentration gradient. Beyond the treatment of glabellar rhytids, there are few, if any, randomized, double blind, placebo-controlled studies on the aesthetic uses of BoNTA-ABO. This guide summarizes what is known and serves as a basis for clinical use and continued understanding.