Conversion ratio between different botulinum neuroprotein product in neurological practice

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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

SPIN RSCI: 9007-4907
Scopus AuthorID: 7006342537
ORCID: 0000-0003-2225-3642

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.

SPIN RSCI: 7310-8913
Scopus AuthorID: 55545730000
ORCID: 0000-0003-4255-7029

Zakharov D.V.

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

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