Objectives

Onabotulinum toxin A (ONA, Botox®) and abobotulinum toxin A (ABO, Dysport®) are most frequently used in the treatment of movement disorders. The aim of this study was to identify the dose conversion ratio (ABO dose:ONA dose), comparative efficacy, and adverse events in patients who switched from ONA to ABO.

Methods

There were 64 patients with cervical dystonia (39), hemifacial spasm (16), oromandibular dystonia (5), blepharospasm (3), and extremity dystonia (1) who switched from ONA to ABO. The efficacy, adverse events, duration of action, and severity of the adverse events after the final dose of ONA, initial dose of ABO, and second dose of ABO were investigated in these patients.

Results

The mean dose conversion ratio was 4.70 (2.27–9.62). The mean efficacy of the final ONA injection was 70.62%; initial ABO injection, 72.27%; and second ABO injection, 73.52%, which showed improvement on a visual analog scale (p = 0.71, p = 0.5). Incidence of adverse events after the final ONA injection was 18.8%; this increased to 39.1% after the initial ABO injection (p < 0.001) and decreased to 14.1% after the second ABO injection (p = 0.77). After the initial ABO injection, 20% of the adverse events were trivial, 36% were mild, and 32% were severe. After the second ABO injection, 7.8% of the adverse events were mild and 6.3% were severe.

Conclusion

Although the mean dose conversion ratio was 4.70, the range was very wide (approximately 2–9). Therefore, we conclude that after the switch from Botox to Dysport, the doses should be tailored to the patients’ clinical situation at treatment initiation, without using a dose conversion ratio.

中文翻译：

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从肉毒杆菌毒素 A 转换为肉毒杆菌毒素 A 治疗神经系统疾病后的剂量转换比、比较疗效和不良事件

目标

Onabotulinum toxin A (ONA, Botox®) 和 abobotulinum toxin A (ABO, Dysport®) 最常用于治疗运动障碍。本研究的目的是确定从 ONA 转换为 ABO 的患者的剂量转换比（ABO 剂量：ONA 剂量）、比较疗效和不良事件。

方法

有颈部肌张力障碍（39）、面肌痉挛（16）、口下颌肌张力障碍（5）、眼睑痉挛（3）和四肢肌张力障碍（1）的64例患者从ONA转为ABO。在这些患者中研究了最终剂量 ONA、初始剂量 ABO 和第二剂量 ABO 后的疗效、不良事件、作用持续时间和不良事件的严重程度。

结果

平均剂量转换比为 4.70 (2.27–9.62)。最后一次 ONA 注射的平均疗效为 70.62%；初始 ABO 注射，72.27%；第二次 ABO 注射，73.52%，在视觉模拟量表上显示出改善（p = 0.71，p = 0.5）。最后一次 ONA 注射后的不良事件发生率为 18.8%；在第一次注射 ABO 后，这一比例增加到 39.1% (p < 0.001)，在第二次注射 ABO 后下降到 14.1% (p = 0.77)。在初始 ABO 注射后，20% 的不良事件是轻微的，36% 是轻微的，32% 是严重的。第二次 ABO 注射后，7.8% 的不良事件为轻度，6.3% 为重度。

结论

尽管平均剂量转换比为 4.70，但范围非常宽（约 2-9）。因此，我们得出结论，在从 Botox 转换为 Dysport 后，应根据患者在治疗开始时的临床情况调整剂量，而不使用剂量转换比。