The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-4329
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2026
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Orlova O.R.

Moskovskiĭ nauchno-prakticheskiĭ Tsentr dermatovenerologii i kosmetologii Departamenta zdravookhraneniia Moskvy, 119071, Moskva, Rossiĭskaia Federatsiia

Timerbaeva S.L.

Research Center of Neurology, Moscow, Russia

Khat’kova S.E.

Federal state budgetary institution «Medical and Rehabilitation Center», Moscow

Kostenko E.V.

Poliklinika vosstanovitel'nogo lecheniia #7;
Kafedra nevrologii i neĭrokhirurgii Rossiĭskogo gosudarstvennogo meditsinskogo universiteta;
Kafedra nevrologii Moskovskogo gosudarstvennogo mediko-stomatologicheskogo universiteta

Krasavina D.A.

Zakharov D.V.

Tsentral'naia gorodskaia klinicheskaia bol'nitsa, g. Velikiĭ Novgorod

Conversion ratio between different botulinum neuroprotein product in neurological practice

Authors:

Orlova O.R., Timerbaeva S.L., Khat’kova S.E., Kostenko E.V., Krasavina D.A., Zakharov D.V.

More about the authors

Journal: S.S. Korsakov Journal of Neurology and Psychiatry. 2017;117(9): 132‑141

DOI: 10.17116/jnevro201711791132-141

Read: 13384 times

Download PDF (RU)
Contact the author
Table of contents

CONVERSION RATIO BETWEEN DIFFERENT BOTULINUM NEUROPROTEIN PRODUCT IN NEUROLOGICAL PRACTICE
CONVERSION RATIO BETWEEN DIFFERENT BOTULINUM NEUROPROTEIN PRODUCT IN NEUROLOGICAL PRACTICE

To cite this article:

Orlova OR, Timerbaeva SL, Khat’kova SE, Kostenko EV, Krasavina DA, Zakharov DV. Conversion ratio between different botulinum neuroprotein product in neurological practice. S.S. Korsakov Journal of Neurology and Psychiatry. 2017;117(9):132‑141. (In Russ.)
https://doi.org/10.17116/jnevro201711791132-141

Подписка 2026 Журнал неврологии и психиатрии им. С.С. Корсакова (S.S. Korsakov Journal of Neurology and Psychiatry)
МСФ на ЯМ
Использование инфографики авторами научных работ
Close metadata
Recommended articles:
Comparative analysis of the effe­ctiveness of Botu­linum toxin type A — hema­gglutinin preparations of the Rela­tox and Botox complex in the treatment of patients with primary idiopathic blepharospasm. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(2):86-90
Immu­nogenicity of botu­linum toxin products: the emergence of resi­stance and ways to overcome it. Plastic Surgery and Aesthetic Medi­cine. 2025;(1):125-134
Classification criteria for ante­rior abdo­minal wall defo­rmities. Piro­gov Russian Journal of Surgery. 2025;(9):19-28
Abstract:

Despite nearly 30 years of experience in the application of botulinum toxin type A (BTA) in clinical practice, many fundamental questions of therapy remain valid. There are 5 botulinum toxin type A used for neurological indications in the Russian Federation in 2017. They contain different number of active neuroprotein (150 kDa) in a therapeutic dose of the drug that may have a potential impact on the efficacy and duration of action. The current SmPC of each BTA stated that the unit of activity is unique and can not be compared with any other BTA. In scientific publications one can find many details concerning the equivalence doses of onabotulinumtoxin A (botox) and abobotulinumtoxin A (dysport) and the ratio of units varies from 1:1 to 1:11. However, according to clinical guidelines, systematic reviews and high quality research evidence of recent years, the ratio of units of abobotulinumtoxin A (dysport) and onabotulinumtoxin A (botox) is 3(2,5):1. Use of a fixed ratio of units is possible only when switching from one drug to another or in case of limiting access to specific drug. Botulinum toxin type A is the first line of therapy in the treatment of several neurological diseases. The most commonly used drugs of botulinum toxin type A (botox, dysport, xeomin) have a significant evidence base that confirms their efficacy and optimal safety profile. The main difference between botulinum toxin type A is their potential activity of action, i.e., activity units and total therapeutic dose.

Keywords:

botulinum toxin A (BTA)
dysport
botox
xeomin
active neurotoxin
biological activity of BTA
ratio units
diffusion
distribution
immunogenicity

Authors:

Orlova O.R.

Moskovskiĭ nauchno-prakticheskiĭ Tsentr dermatovenerologii i kosmetologii Departamenta zdravookhraneniia Moskvy, 119071, Moskva, Rossiĭskaia Federatsiia

Timerbaeva S.L.

Research Center of Neurology, Moscow, Russia

Khat’kova S.E.

Federal state budgetary institution «Medical and Rehabilitation Center», Moscow

Kostenko E.V.

Poliklinika vosstanovitel'nogo lecheniia #7;
Kafedra nevrologii i neĭrokhirurgii Rossiĭskogo gosudarstvennogo meditsinskogo universiteta;
Kafedra nevrologii Moskovskogo gosudarstvennogo mediko-stomatologicheskogo universiteta

Krasavina D.A.

Zakharov D.V.

Tsentral'naia gorodskaia klinicheskaia bol'nitsa, g. Velikiĭ Novgorod

Close metadata

References:

  1. Carruthers J. Consensus Recommendations for Combined Aesthetic Interventions in the Face Using Botulinum Toxin, Fillers, and Energy-Based Devices. Dermatol Surg. 2016;42(5):586-597. https://doi.org/10.1097/DSS.0000000000000754
  2. Evidente VG. Botulinum toxin therapy for cervical dystonia: the science of dosing. Tremor Other Hyperkinet Mov (NY). 2014;4:273. https://doi.org/10.7916%2FD84X56BF
  3. Maas C. Current aesthetic use of abobotulinumtoxinA in clinical practice: an evidence-based consensus review. Aesthet Surg J. 2012;32(1 suppl):8-29. https://doi.org/10.1177/1090820X12455192
  4. Turner-Stokes L, Ashford S, Bhakta B. Spasticity in adults: management using botulinum toxin. National guidelines. ROYAL COLLEGE OF PHYSICIANS. 2009.
  5. Klinicheskie recomendatsii «Diahnostika I lechenie sindroma spastichnosti u patsientov s ochagovimi porazheniyami tsentral;noj nervnoj sistemi I ih posledstviyami, v ramkah okazaniya statsionarnoj I ambulatorno-policlinicheskoy meditsinskoj pomoschi». 2016. (In Russ.).
  6. Klinicheskie recomendatsii «Dystonia: diagnostika I lechenie». 2016. (In Russ.).
  7. Frevert J. Content of Botulinum Neurotoxin in Botox/Vistabel, Dysport/Azzalure, and Xeomin/Bocouture. Drugs R D. 2010;10(2):67-73. https://doi.org/10.2165/11584780-000000000-00000
  8. Frevet J. Pharmaceutical, Biological, and Clinical Properties of Botulinum Neurotoxin Type A Products. Drugs R D. 2015;15:1-9. https://doi.org/10.1007%2Fs40268-014-0077-1
  9. Brin MF. Botulinum toxin type A products are not interchangeable: a review of the evidence. Biologics: Targets and Therapy. 2014;8:227-241. https://doi.org/10.2147%2FBTT.S65603
  10. Scaglione F. Conversion Ratio between Botox, Dysport, and Xeomin in Clinical Practice. Toxins. 2016;8:65. https://doi.org/10.3390/toxins8030065
  11. Foad Nahai, Lorenc ZP. A Review of AbobotulinumtoxinA (Dysport) Aesthetic Surgery Journal. 2013;33(1). https://doi.org/10.1177/1090820X12474632
  12. Orlova OR. Vozhmozhnosti I perspective ispol’zovaniya botuloksina v klinicheskoj praktike. RMZh 2006;23:1700. (In Russ.).
  13. Chen JJ, Dashtipour K. Abo-, Inco-, Ona-, and Rima-Botulinum toxins in clinical therapy: A primer. Pharmacotherapy. 2013;33:304-318. https://doi.org/10.1002/phar.1196
  14. Keller JE. Recovery form botulinum neurotoxin poisoning in vivo. Neuroscience. 2006;139:629-637. https://doi.org/10.1016/j.neuroscience.2005.12.029
  15. Wohlfarth K, Sycha T, Ranoux D, Naver H, Caird D. Dose equivalence of two commercial preparations of botulinum neurotoxin type A: Time for a reassessment? Current medical research and opinion. 2009;25(7):1573-1584. https://doi.org/10.1185/03007990903028203
  16. Kranz G. Respective potencies of Botox and Dysport in a human skin model: a randomized, double-blind study. Movement Disorders. 2008;24(2):231-236. https://doi.org/10.1002/mds.22336
  17. Marchetti A, Magar R, Findley L, Larsen JP, Pirtosek Z, Růzicka E, Jech R, Sławek J, Ahmed F. Retrospective Evaluation of the Dose of Dysport and BOTOX in the Management of Cervical Dystonia and Blepharospasm: The REAL DOSE Study. Mov Disord. 2005;20(8):937-944. https://doi.org/10.1002/mds.20468
  18. Wohlfarth K, Schwandt I, Wegner F, Jürgens T, Gelbrich G, Wagner A, Bogdahn U, Schulte-Mattler W. Biological activity of two botulinum toxin type A complexes (Dysport and Botox) in volunteers: a double-blind, randomized, dose-ranging study. J Neurol. 2008;255(12):1932-1939. https://doi.org/10.1007/s00415-008-0031-7
  19. Simpson D, Hallett M, Ashman EJ, Comella CL, Green MW, Gronseth GS, Armstrong MJ, Gloss D, Potrebic S, Jankovic J, Karp BP, Naumann M, So YT, Yablon SA. Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2016;86(19):1818-1826. https://doi.org/10.1212/WNL.0000000000002560
  20. кол. авт.]. Под ред С.Л. Тимербаевой. М.: Практическая медицина; 2014. [Азбука ботулинотерапии: научно-практическое издание. [кол. авт.]. Под ред. Тимербаевой С.Л. М.: Практическая медицина; 2014. (In Russ.).
  21. Wissel J. European consensus table on the use of botulinum toxin type in adult spasticity. J Rehabil Med. 2009;41:13-25. https://doi.org/10.2340/16501977-0303
  22. Love SC. Botulinum toxin assessment, intervention and after-care for lower limb spasticity in children with cerebral palsy: international consensus statement. European Journal of Neurology. 2010;(suppl 2):9-37. https://doi.org/10.1111/j.1468-1331.2010.03126.x
  23. Sampaio C, Costa J, Ferreira JJ. Clinical comparability of marketed formulations of botulinum toxin. Mov Disord. 2004;19(suppl 8):129-136. https://doi.org/10.1002/mds.20066
  24. Dashtipour K. Onabotulinumtoxin A and Abobotulinumtoxin A Dose Conversion: a Systematic Literature Review. Mov Disord Clin Pract. 2016;3(2):109-115. https://doi.org/10.1002/mdc3.12235
  25. Karsai S. Current evidence on the Unit Equivalence of different Botulinum Neurotoxin A Formulations and Recommendations for Clinical Practice in Dermatology. Dermatol Surg. 2009;35(1):1-8. https://doi.org/10.1111/j.1524-4725.2008.34375.x
  26. Ravenni R, De Grandis D, Mazza A. Conversation ratio between Dysport and Botox in clinical practice: an overview of available evidence. Neurol Sei. 2013;34:1043-1048. https://doi.org/10.1007/s10072-013-1357-1
  27. Rosales R. Pharmacology of botulinum toxin: differences between type A preparations. European Journal of Neurology. 2006;13(1):2-10. https://doi.org/10.1111/j.1468-1331.2006.01438.x
  28. Van den Bergh PYK, Lison DF. Dose standardization of botulinum toxin. Adv Neurol. 1998;78:231-235.
  29. Hexsel D, Brum C, do Prado DZ, Soirefmann M, Rotta FT, Rodrigues TC. Field effect of two commercial preparations of botulinum toxin type A: a prospective, double-blind, randomized clinical trial. J Am Acad Dermatol. 2012;67:226-232. https://doi.org/10.1016/j.jaad.2011.08.011
  30. Karsai S, Adrian R, Hammes S, Thimm J, Raulin C. A randomized double-blind study of the effect of botox and dysport/reloxin on forehead wrinkles and electromyographic activity. Arch Dermatol. 2007;143:1447-1449. https://doi.org/10.1001/archderm.143.11.1447-b
  31. Kassir R, Kolluru A, Kassir M. Triple-blind, prospective, internally controlled comparative study between abobotulinumtoxina and onabotulinumtoxina for the treatment of facial rhytids. Dermatol Ther (Heidelb). 2013;3:179-189. https://doi.org/10.1007/s13555-013-0033-y
  32. Nestor MS, Ablon GR. Duration of action of abobotulinumtoxina and onabotulinumtoxina: a randomized, double‐blind study using a contralateral frontalis model. J Clin Aesthet Dermatol. 2011;4:43-49.
  33. Benecke R. Clinical Relevance of Botulinum Toxin Immunogenicity. Biodrugs. 2012:26(2):1-9. https://doi.org/10.2165/11599840-000000000-00000
  34. Brin MF, Comella CL, Jankovic J, Lai F, Naumann M. Long-term treatment with botulinum toxin type A in cervical dystonia has low immunogenicity by mouse protection assay. Mov Disord. 2008;23(10):1353-1360. https://doi.org/10.1002/mds.22157
  35. Carli L, Montecucco C, Rossetto O. Assay of diffusion of different botulinum neurotoxin type A formulations injected in the mouse leg. Muscle Nerve. 2009;40(3):374-380. https://doi.org/10.1002/mus.21343
  36. Karsai S. Do different formulations of botulinum toxin type A really have different migration characteristics? Journal of Cosmetic Dermatology. 2008;7(3):230. https://doi.org/10.1111/j.1473-2165.2008.00395.x
  37. Park J. Profile of Xeomin (incobotulinumtoxin A) for the treatment of blepharospasm. Clin Ophthalmol. 2011;5:725-732. https://doi.org/10.2147/OPTH.S13978
  38. Wortzman М. The science and manufacturing behind botulinum neurotoxin type A-ABO in clinical use. Aesthet Surg J. 2009;29(6 suppl):34-42. https://doi.org/10.1016/j.asj.2009.09.014
  39. Hallett M. Explanation of timing of botulinum neurotoxin effects, onset and duration, and clinical ways of influencing them. Toxicon. 2015;107(PtA):64-67. https://doi.org/10.1016/j.toxicon.2015.07.013
  40. Eisele KH, Fink K, Vey M, Taylor HV. Studies on the dissociation of botulinum neurotoxin type A complexes. Toxicon. 2011;57:555-565. https://doi.org/10.1016/j.toxicon.2010.12.019
  41. Hexsel D, Dal’Forno T, Hexsel C, Do Prado DZ, Lima MM. A randomized pilot study comparing the action halos of two commercial preparations of botulinum toxin type A. Dermatol Surg. 2008;34:52-59. https://doi.org/10.1111/j.1524-4725.2007.34008.x
  42. Joel L Cohen. Safety and Patient Satisfaction of AbobotulinumtoxinA for Aesthetic Use: A Systematic Review. Aesthet Surg J. 2017;37(suppl 1):32-44. https://doi.org/10.1093/asj/sjx010
  43. Fabbri M. Neutralizing Antibody and Botulinum Toxin Therapy: A Systematic Review and Meta-analysis. Neurotox Res. 2016;29(1):105-117. https://doi.org/10.1007/s12640-015-9565-5
  44. Mohammadi B, Buhr N, Bigalke H, Krampfl K, Dengler R, Kollewe K. A long-term follow-up of botulinum toxin A in cervical dystonia. Neurol Res. 2009;31(5):463-466. https://doi.org/10.1179/174313209X405137
Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.