July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Switchover study of onabotulinumtoxinA to incobotulinumtoxinA for facial dystonia
Author Affiliations & Notes
  • John Bladen
    Ophthalmology, Queen Victoria Hospital, East Grinstead, East Grinstead, ENGLAND, United Kingdom
  • Maribel Favor
    Ophthalmology, Queen Victoria Hospital, East Grinstead, East Grinstead, ENGLAND, United Kingdom
  • Andre Litwin
    Ophthalmology, Queen Victoria Hospital, East Grinstead, East Grinstead, ENGLAND, United Kingdom
  • Raman Malhotra
    Ophthalmology, Queen Victoria Hospital, East Grinstead, East Grinstead, ENGLAND, United Kingdom
  • Footnotes
    Commercial Relationships   John Bladen, None; Maribel Favor, None; Andre Litwin, None; Raman Malhotra, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 6226. doi:
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      John Bladen, Maribel Favor, Andre Litwin, Raman Malhotra; Switchover study of onabotulinumtoxinA to incobotulinumtoxinA for facial dystonia . Invest. Ophthalmol. Vis. Sci. 2019;60(9):6226.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Clinical effectiveness and efficiency of incobotulinumtoxinA (Xeomin®) compared to onabotulinumtoxinA (Botox®) in facial dystonia is unclear. The purpose of the study was to evaluate switching from Botox® to Xeomin® in the treatment of essential blepharospasm (EB), hemifacial spasm (HFS) and aberrant facial nerve regeneration (AFR).

Methods : A retrospective study of a prospective, single-masked switchover audit from Botox® to Xeomin® was performed. Patients were masked to the switchover as the product was always referred to as Botulinum A toxin. A 1:1 unit dose ratio was utilized. Efficacy assessments were completed contemporaneously at each visit. Validated objective assessments included blepharospasm disability score (BDS) and Jankovic score (JS). Subjective evaluation comprised treatment satisfaction (using a percentage rating scale of 0-100 with 100% as very satisfied), duration of maximum effect (DME) in weeks and complications. A minimum of 3 Xeomin® and 3 Botox® regimens were administered to 20 patients over a minimum of 2 years.

Results : Twenty EB, 12 HFS and 6 AFR received 114 Botox® and 114 Xeomin® treatments. Both brands had similar efficacy, but SI (P<0.001) and DME (P<0.05) were higher in the HFS group with Xeomin®. Complications: bruising (2 Botox®, 1 Xeomin®); ptosis (3 Botox®, 0 Xeomin®). Botox was 33% pricier.

Conclusions : Switching from Botox® to Xeomin® didn’t result in an inferior outcome for the treatment of facial dystonia and led to a cost-saving.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

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