Aim:Incobotulinumtoxin A(xeomin)has been proposed as an alternative to abobotulinumtoxin A(dysport)and onabotulinumtoxin A(Botox)in the treatment of glabellar frown lines.A recent study is comparing abobotulinumtoxin ...Aim:Incobotulinumtoxin A(xeomin)has been proposed as an alternative to abobotulinumtoxin A(dysport)and onabotulinumtoxin A(Botox)in the treatment of glabellar frown lines.A recent study is comparing abobotulinumtoxin A and onabotulinumtoxin A revealed equivalent efficacy with a dose conversion ratio of 2.5:1.We sought to establish effectiveness and dosing equivalency of incobotulinumtoxin A vs.abobotulinumtoxin A.Methods:Inclusion criteria for this pilot study included patients of a single surgeon(LAC)who had previously received a constant dose of abobotulinumtoxin A over at least four consecutive treatment sessions for the previous 12 months to achieve an 85-90%elimination of dynamic glabellar frown lines.The primary outcome sought dose comparison between established maintenance abobotulinumtoxin A dosing and incobotulinumtoxin A first-time dosing.A 2:1 conversion(abobotulinumtoxin A:incobotulinumtoxin A)was chosen in most patients.Secondary outcomes were patient-reported onset of effect,physician-assessed effect at 10-12 weeks,pain associated with administration,and patient perceived need for re-treatment at 2 weeks.Results:A total of 32 subjects were included.The mean dose of incobotulinumtoxin A was 17.1 units(±6.1,the median dose 20 units).The mean dose of abobotulinumtoxin A was 27.6(±11.7,the median dose 27.5 units).The mean difference in treatment units was 10.5(95%confidence interval,P<0.001).Among 30 patients who reported effect onset,the median was 8.5 days,with a range of 1-14.At 10-12 weeks,muscle paralysis was assessed to be 69.2%(±27.3),vs.90.3%(±1.8)with abobotulinumtoxin A(P<0.001).The majority of patients rated pain of administration as equal or greater to that of abobotulinumtoxin A(63%and 22%,respectively).Three patients(9%)required re-treatment at 2 weeks with abobotulinumtoxin A due to lack of effective treatment with incobotulinumtoxin A.Abobotulinumtoxin A re-treatment was chosen by the patient.Conclusion:We found incobotulinumtoxin A at 17.1(±6.1)units to be less effective than abobotulinumtoxin A at 27.6(±11.7)units in the treatment of glabellar frown lines at 10-12 weeks postadministration.Dosing was less predictable than dosing associated with abobotulinumtoxin A treatment.Larger,randomized controlled trials are indicated to further delineate these differences and to clarify whether this difference from previously published incobotulinumtoxin A dosing may have been due to the small sample size.展开更多
文摘Aim:Incobotulinumtoxin A(xeomin)has been proposed as an alternative to abobotulinumtoxin A(dysport)and onabotulinumtoxin A(Botox)in the treatment of glabellar frown lines.A recent study is comparing abobotulinumtoxin A and onabotulinumtoxin A revealed equivalent efficacy with a dose conversion ratio of 2.5:1.We sought to establish effectiveness and dosing equivalency of incobotulinumtoxin A vs.abobotulinumtoxin A.Methods:Inclusion criteria for this pilot study included patients of a single surgeon(LAC)who had previously received a constant dose of abobotulinumtoxin A over at least four consecutive treatment sessions for the previous 12 months to achieve an 85-90%elimination of dynamic glabellar frown lines.The primary outcome sought dose comparison between established maintenance abobotulinumtoxin A dosing and incobotulinumtoxin A first-time dosing.A 2:1 conversion(abobotulinumtoxin A:incobotulinumtoxin A)was chosen in most patients.Secondary outcomes were patient-reported onset of effect,physician-assessed effect at 10-12 weeks,pain associated with administration,and patient perceived need for re-treatment at 2 weeks.Results:A total of 32 subjects were included.The mean dose of incobotulinumtoxin A was 17.1 units(±6.1,the median dose 20 units).The mean dose of abobotulinumtoxin A was 27.6(±11.7,the median dose 27.5 units).The mean difference in treatment units was 10.5(95%confidence interval,P<0.001).Among 30 patients who reported effect onset,the median was 8.5 days,with a range of 1-14.At 10-12 weeks,muscle paralysis was assessed to be 69.2%(±27.3),vs.90.3%(±1.8)with abobotulinumtoxin A(P<0.001).The majority of patients rated pain of administration as equal or greater to that of abobotulinumtoxin A(63%and 22%,respectively).Three patients(9%)required re-treatment at 2 weeks with abobotulinumtoxin A due to lack of effective treatment with incobotulinumtoxin A.Abobotulinumtoxin A re-treatment was chosen by the patient.Conclusion:We found incobotulinumtoxin A at 17.1(±6.1)units to be less effective than abobotulinumtoxin A at 27.6(±11.7)units in the treatment of glabellar frown lines at 10-12 weeks postadministration.Dosing was less predictable than dosing associated with abobotulinumtoxin A treatment.Larger,randomized controlled trials are indicated to further delineate these differences and to clarify whether this difference from previously published incobotulinumtoxin A dosing may have been due to the small sample size.
