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Published on: November 9, 2016
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Conversion Ratio between Botox®, Dysport®, and Xeomin® in Clinical Practice
1Department of Oncology and Onco-Hematology, University of Milan, Via Vanvitelli 32, 20129 Milan, Italy. francesco.scaglione@unimi.it.
Toxins
|March 10, 2016
Summary
Comparing botulinum neurotoxin type A products for spasticity treatment, this study provides guidance on potency and safety. Incobotulinum toxin A (INCO) is as effective as onabotulinum toxin-A (ONA) at a 1:1 ratio, while abobotulinum toxin-A (ABO) may require a 3:1 ratio.
Area of Science:
- Neurology
- Pharmacology
- Biochemistry
Background:
- Botulinum neurotoxin type A (BoNT-A) is crucial for treating spasticity globally.
- Three main BoNT-A products exist in the Western Hemisphere: onabotulinumtoxin-A (ONA), abobotulinumtoxin-A (ABO), and incobotulinumtoxin-A (INCO).
- Debate exists regarding the comparability and clinical conversion ratios of these BoNT-A preparations.
Purpose of the Study:
- To provide clinical guidance on the use of different BoNT-A products.
- To address issues of potency, conversion ratios, toxin spread, and immunogenicity.
- To compare the efficacy, safety, and cost-effectiveness of ONA, ABO, and INCO.
Main Methods:
- Review of clinical and preclinical data on BoNT-A preparations.
- Analysis of efficacy and safety profiles across different products.
- Evaluation of conversion ratios for clinical application in spasticity and other conditions.
Main Results:
- Incobotulinum toxin A (INCO) demonstrated comparable efficacy and safety to onabotulinumtoxin-A (ONA) using a 1:1 conversion ratio.
- A conversion ratio of 3:1 or lower for abobotulinumtoxin-A (ABO) to ONA appears appropriate for treating spasticity, cervical dystonia, and blepharospasm/hemifacial spasm, with higher ratios risking overdose.
- Abobotulinumtoxin-A (ABO) offers a better cost-efficacy profile compared to other products when dosed appropriately.
Conclusions:
- Clinical conversion ratios are essential for safe and effective BoNT-A therapy.
- While efficacies are similar, differences in potency and cost-effectiveness exist among ONA, ABO, and INCO.
- Further research into factors influencing toxin spread and immunogenicity is warranted.
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