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Toxins 2016, 8(3), 65;

Conversion Ratio between Botox®, Dysport®, and Xeomin® in Clinical Practice

Department of Oncology and Onco-Hematology, University of Milan, Via Vanvitelli 32, 20129 Milan, Italy
Academic Editor: Flaminia Pavone
Received: 21 December 2015 / Revised: 23 February 2016 / Accepted: 26 February 2016 / Published: 4 March 2016
(This article belongs to the Section Bacterial Toxins)
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Botulinum neurotoxin has revolutionized the treatment of spasticity and is now administered worldwide. There are currently three leading botulinum neurotoxin type A products available in the Western Hemisphere: onabotulinum toxin-A (ONA) Botox®, abobotulinum toxin-A (ABO), Dysport®, and incobotulinum toxin A (INCO, Xeomin®). Although the efficacies are similar, there is an intense debate regarding the comparability of various preparations. Here we will address the clinical issues of potency and conversion ratios, as well as safety issues such as toxin spread and immunogenicity, to provide guidance for BoNT-A use in clinical practice. INCO was shown to be as effective as ONA with a comparable adverse event profile when a clinical conversion ratio of 1:1 was used. The available clinical and preclinical data suggest that a conversion ratio ABO:ONA of 3:1—or even lower—could be appropriate for treating spasticity, cervical dystonia, and blepharospasm or hemifacial spasm. A higher conversion ratio may lead to an overdosing of ABO. While uncommon, distant spread may occur; however, several factors other than the pharmaceutical preparation are thought to affect spread. Finally, whereas the three products have similar efficacy when properly dosed, ABO has a better cost-efficacy profile. View Full-Text
Keywords: botulinum neurotoxin; onabotulinum toxin-A; abobotulinum toxin-A; incobotulinum toxin A botulinum neurotoxin; onabotulinum toxin-A; abobotulinum toxin-A; incobotulinum toxin A
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Scaglione, F. Conversion Ratio between Botox®, Dysport®, and Xeomin® in Clinical Practice. Toxins 2016, 8, 65.

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