Switch from abobotulinumtoxinA (Dysport®) to incobotulinumtoxinA (Xeomin®) botulinum toxin formulation: A review of 257 cases

Abstract

For patients with conditions commonly treated in dystonia clinics, switching from abobotulinumtoxinA to incobotulinumtoxinA, given at equivalent doses (~4:1 unit ratio) at similar intervals, was effective, well tolerated and achieved cost savings.

Botulinum Neurotoxin Revisited – An Individualised, Patient-centric Approach for the Treatment of Dystonia and Spasticity

“…77 Recent studies suggest that 1:4 may be more appropriate. 73,78 AE rates are comparable for all three products with conversion ratios of 1:1 for onaBoNT-A and incoBoNT-A; and 1:4 for incoBoNT-A/onaBoNT-A and aboBoNT-A. 68,79 In summary, in terms of a patient-centric approach, all three…”

Botulinum Toxin Treatment of Blepharospasm, Orofacial/Oromandibular Dystonia, and Hemifacial Spasm

“…Serotype A toxins appear to be equivalent in terms of outcome, adverse events, and patient preference. 22,39 An open study of rimaBoNT-B for HFS showed similar extent of benefit, but shorter duration. 78 RimabotulinumtoxinB had a higher incidence of burning pain with injection, likely due to its slightly acidic solution.…”

“…Long-term evaluation has yet to identify differences in clinical profile, patient preference, peak response, duration of benefit, or adverse events between the serotype A toxins. 16,22,25,[37][38][39] Type B toxin, (rimabotulinumtoxinB [rimaBoNT-B]) has rarely been studied in blepharospasm. The use of type B toxin may be associated with more pain on injection, as the toxin is packaged in a solution with a slightly acidic pH.…”

“…IncoBoNT-A and onaBoNT-A are typically diluted to a concentration of 5 U/0.1 cc; aboBoNT-A to 20 U/0.1 cc. 22,39,79 A single study comparing dilutions of 5 U/0.1 cc and 2.5 U/0.1 cc onaBoNT-A for HFS showed a longer duration for the more concentrated injectate, but more pronounced and longer lasting weakness. 80…”

Myaesthenia gravis exacerbation caused by axillary injection of botulinum toxin A for treatment of hyperhidrosis

“…It is available as onabotulinumtoxin (Botox; Allergan Ltd, Marlow, Buckinghamshire, UK), abotoulinumtoxin (Dysport) and incobotulinumtoxin A (Xeomin). These preparations are not bioequivalent; the conversion ratios are approximately Dysport 4 U to Xeomin 1 U to Botox 1 U . BTX is injected intradermally, divided into aliquots covering the area affected.…”