Six-Month Comparative Analysis Monitoring the Progression of the Largest Diameter of the Sweating Inhibition Halo of Different Botulinum Toxins Type-A

Abstract

Background Excessive sweating is a clinical condition that can be improved with type-A botulinum toxin (BTX-A). Objectives To evaluate and compare the largest diameter of sweating inhibition halo (SIH) of 5 different commercially available BTX-A, in five different doses, in a 6-month-long clinical evaluation. Methods Twenty-five adult female volunteers were injected in the dorsal trunk area with both 100 units (100UI) and 500 units (500UI) BTX-A products, reconstituted in a ratio of 1:2.5 IU, respectively. Products were applied in five different concentrations (1:2.5U, 2:5U, 3:7.5U, 4:10U, and 5:12.5U). After 30, 60, 90, 120, 150, and 180 days, a starch-iodine test was performed to obtain the largest diameter of each SIH. Results The higher the number of units used, the larger the SIH p < 0.05 for all BTX-A. However, Botox®, Botulift®, Dysport®, and Prosigne® have pretty likewise SIH along the study, with some few differences for some doses and months between one and another. However, Xeomin® is the BTX-A with the smallest SIH, in comparison with all others, in any dose and period. Conclusions Differences were observed among all brands of BTX-As, based on dose and time after injection. Xeomin® provides the smallest SIH in comparison with others BTX-A. Level of Evidence: 2

OnabotulinumtoxinA Displays Greater Biological Activity Compared to IncobotulinumtoxinA, Demonstrating Non-Interchangeability in Both In Vitro and In Vivo Assays

“…Since the introduction of incobotA (Merz Pharmaceuticals received FDA approval in 2010), there has been on-going debate within the literature as to the interchangeability of incobotA and onabotA at a uniform clinical dose conversion (1:1) ratio across a variety of indications (reviewed in [ 19 , 20 , 26 , 37 , 38 ]). Many studies refute the interchangeability of these products [ 24 , 25 , 39 , 40 , 41 , 42 ] and highlight that differences in injection volumes, patterns, and techniques, as well as distribution/diffusion patterns and other factors, vary between BoNT/A products [ 26 ]. For example, Moers-Carpi et al found that 20 U of onabotA was as effective as 30 U of incobotA at treating glabellar lines in a randomized, double-blind study [ 24 ], demonstrating the non-interchangeability of units of onabotA and incobotA in this indication.…”

Safety and efficacy of botulinum toxin type A in preventing and treating scars in animal models: A systematic review and meta‐analysis

“… 45 , 46 The diffusion coefficient between different BTXA products and between different doses of each product may be different. 47 , 48 …”

“…Different BTXA products have different efficacies at the same doses; thus, dosage equivalence is a noteworthy issue 45,46 . The diffusion coefficient between different BTXA products and between different doses of each product may be different 47,48 …”

<p>One21: A Novel, Customizable Injection Protocol for Treatment of the Forehead with IncobotulinumtoxinA</p>

“…As data suggest diffusion characteristics may differ between the botulinum toxin preparations, no conclusions can be drawn about the applicability of this technique to other botulinum toxin formulations. 6,7,8 The one21 technique is based on a 3-step protocol, involving careful assessment of the individual anatomy of each patient, with its individual function, mass and strength of the frontalis muscle, in both, the static and dynamic states. Guided by anatomical and functional landmarks, a treatment grid with 21 potential injection points individual to each patient can be defined.…”