A Randomized Pilot Study Comparing the Action Halos of Two Commercial Preparations of Botulinum Toxin Type A

Hexsel, Dóris; DalʼForno, Taciana; Hexsel, Camile L.; Prado, Débora Zechmeister do; Lima, Maryelle Moreira

doi:10.1111/j.1524-4725.2007.34008.x

Cited by 46 publications

(29 citation statements)

References 23 publications

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“…15,16 The scale has the advantage of measuring the field of BoNT-A effect without the need for the Minor’s test, which has often been used to demonstrate localized and/or comparative effects of BoNT-A in areas such as the frontalis. 31-33 The FMS assessment relies on a series of photographs using the same camera settings and lighting conditions with a rest period of 1 minute between photographs (Table 1). Using the frontalis muscle also allows for bilateral (split-face) comparison of different toxins, dosing and technique on a single patient.…”

Section: Definitionsmentioning

confidence: 99%

“…Hexsel et al have demonstrated the relationship between muscle weakening halos and sweating halos in their forehead model. 31-33 Because the face contains so many muscles, an injection site may overlap a non-target muscle, particularly if the toxin diffuses more widely than expected. 35 Conversely, if the toxin used does not develop the same field of effect obtained with another toxin, patients may not achieve the expected results.…”

Section: Definitionsmentioning

confidence: 99%

“…36 However, the findings from more recent studies are consistent with those of Karsai and Raulin. 15,16,31,37,38 A study using a human abdomen, in which subjects received ABO and ONA injections at varying dose ratios into the abdomen, found that dose equivalence could be established at a ratio of 1.9:1.0. 39 …”

Section: Definitionsmentioning

confidence: 99%

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Key Parameters for the Use of AbobotulinumtoxinA in Aesthetics: Onset and Duration

Nestor

Ablon

Pickett

2017

Aesthetic Surgery Journal

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Time to onset of response and duration of response are key measures of botulinum toxin efficacy that have a considerable influence on patient satisfaction with aesthetic treatment. However, there is no overall accepted definition of efficacy for aesthetic uses of botulinumtoxinA (BoNT-A). Mechanical methods of assessment do not lend themselves to clinical practice and clinicians rely instead on assessment scales such as the Frontalis Activity Measurement Standard, Frontalis Rating Scale, Wrinkle Severity Scale, and Subject Global Assessment Scale, but not all of these have been fully validated. Onset of activity is typically seen within 5 days of injection, but has also been recorded within 12 hours with abobotulinumtoxinA. Duration of effect is more variable, and is influenced by parameters such as muscle mass (including the effects of age and sex) and type of product used. Even when larger muscles are treated with higher doses of BoNT-A, the duration of effect is still shorter than that for smaller muscles. Muscle injection technique, including dilution of the toxin, the volume of solution injected, and the positioning of the injections, can also have an important influence on onset and duration of activity. Comparison of the efficacy of different forms of BoNT-A must be made with the full understanding that the dosing units are not equivalent. Range of equivalence studies for abobotulinumtoxinA (Azzalure; Ipsen Limited, Slough UK/Galderma, Lausanne CH/Dysport, Ipsen Biopharm Limited, Wrexham UK/Galderma LP, Fort Worth, TX) and onabotulinumtoxinA (Botox; Allergan, Parsippany, NJ) have been conducted, and results indicate that the number of units of abobotulinumtoxinA needs to be approximately twice as high as that of onabotulinumtoxinA to achieve the same effect. An appreciation of the potential influence of all of the parameters that influence onset and duration of activity of BoNT-A, along with a thorough understanding of the anatomy of the face and potency of doses, are essential to tailoring treatment to individual patient needs and expectations.

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Section: Definitionsmentioning

confidence: 99%

Section: Definitionsmentioning

confidence: 99%

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Key Parameters for the Use of AbobotulinumtoxinA in Aesthetics: Onset and Duration

Nestor

Ablon

Pickett

2017

Aesthetic Surgery Journal

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“…Despite widespread clinical use, comparative dose ratios or conversion factors of BTX-A formulations remain controversial because they have been shown to have differences in efficacy and systemic effects (Kim et al 2013). Hexsel et al (2008) reported similar field effects at a dose equivalence of 2.5:1.0 IU (Dysport®:Botox®) for both muscle and sweat gland activity. Bearing in mind that both authors, Steel et al (1997) and Christiansen et al (2004), applied 5 IU of onabotulinumtoxinA (ona-BoNT/ A; Botox®, Allergan, Inc, Irvine, CA) and based on the reported conversion ratio observed by Hexsel et al (2008) between onabotulinumtoxinA (ona-BoNT/A; Botox®, Allergan, Inc, Irvine, CA), abobotulinumtoxinA (abo-BoNT/A; Dysport ® Ipsen LTD, Wrexham, UK), we decided to apply a single dose of 12.5 IU of Dysport ® BTX-A (corresponding to 5UI Botox®) into the medial region of the orbicularis muscle in the lower eyelid in patients with epiblepharon to ease symptoms and prevent ocular surface complications related to this disease.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of lower eyelid epiblepharon by injection of botulinum toxin A in patients under two years of age

Nava-Castañeda

2013

Nep J Oph

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Introduction: Epiblepharon is characterized by a cutaneous horizontal fold adjacent to the lid margin. Some cases showed spontaneous resolution, others required surgical treatment. We propose a medical treatment with botulinum toxin type A (BTX-A). Objective: To provide clinical evidence of the usefulness of botulinum toxin type A (BTX-A) in patients with lower eyelid epiblepharon. Subjects and methods: This was a prospective, non-randomized, nonmasked study. Patients with lower eyelid epiblepharon with corneal eyelash contact were included in the study. The scale proposed by Khwarg & Lee (1997) was used to assess the epiblepharon clinical evaluation. A single dose of 12.5 IU of BTX-A (Dysport ®) was directly injected into the medial pre-tarsal orbicularis muscle region in the lower eyelid. Patients were evaluated before the injection and at 1, 4, 12 and 24 weeks after the injection. We performed descriptive statistics and Wilcoxon Signed Rank Test, comparing prior injection measurements to post injection measurements at the 24 th week. A p < 0.05 was considered statistically significant. Each eye was separately analyzed. Results: Fourteen eyes of seven Hispanic patients were treated, five female and two male. The mean age was 8.4 months (4 -14 months). The height of the skin-fold, the area of the cornea touched by the cilia and the symptoms score improved after the first week of BTX-A injection and remained so until the end of study (p < 0.05). No major complications were noted. Conclusion: The effect of a single 12.5 IU injection of BTX-A (Dysport ®) into the medial orbicularis muscle portion in the lower eyelid epiblepharon patients successfully improves the clinical signs and symptoms.

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“…orbicularis oculi) 1–2 sites of injection and a quantity of 3–4 units are effective, whereas a large muscle (e.g. gastrocnemius) requires 4–5 injections and 300–400 units [72, 73]. Typically, a spastic muscle initially receives a small quantity (e.g., 10 units) of the toxin in order to evaluate several reactions (e.g., paralysis, allergy).…”

Section: Pharmaceutical Preparations Of Botulinum Neurotoxinsmentioning

confidence: 99%

Botulinum Neurotoxin: The Ugly Duckling

Koussoulakos¹

2009

Eur Neurol

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This review presents a brief account of the most significant biological effects and clinical applications of botulinum neurotoxins, in a way comprehensive even for casual readers who are not familiar with the subject. The most toxic known substances in botulinum neurotoxins are polypeptides naturally synthesized by bacteria of the genus Clostridium. These polypeptides inhibit acetylcholine release at neuromuscular junctions, thus causing muscle paralysis involving both somatic and autonomic innervation. There is substantial evidence that this muscle-paralyzing feature of botulinum neurotoxins is useful for their beneficial influence on more than 50 pathological conditions such as spastic paralysis, cerebral palsy, focal dystonia, essential tremor, headache, incontinence and a variety of cosmetic interventions. Injection of adequate quantities of botulinum toxins in spastic muscles is considered as a highly hopeful procedure for the treatment of people who suffer from dystonia, cerebral palsy or have experienced a stroke. So far, numerous and reliable studies have established the safety and efficacy of botulinum neurotoxins and advocate wider clinical therapeutic and cosmetic applications.

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A Randomized Pilot Study Comparing the Action Halos of Two Commercial Preparations of Botulinum Toxin Type A

Abstract: Injections of Dysport and BOTOX at an equivalence ratio of 2.5:1 U, respectively, applied at the same volume and depth, using the same technique resulted in similar action halos with regard to muscular and sweat gland activity. Both products seem to be safe and very predictable.

Cited by 46 publications

References 23 publications

Key Parameters for the Use of AbobotulinumtoxinA in Aesthetics: Onset and Duration

Key Parameters for the Use of AbobotulinumtoxinA in Aesthetics: Onset and Duration

Successful treatment of lower eyelid epiblepharon by injection of botulinum toxin A in patients under two years of age

Botulinum Neurotoxin: The Ugly Duckling

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