title: Switch from abobotulinumtoxinA (Dysport®) to incobotulinumtoxinA (Xeomin®) botulinum toxin formulation: a review of 257 cases.
abstract: OBJECTIVE
  To explore the dose equivalence ratio and treatment costs for abobotulinumtoxinA and incobotulinumtoxinA for patients with focal dystonias.
  
  
  METHODS
  Patient chart review.
  
  
  METHODS
  Adult patients with blepharospasm (n = 19), cervical dystonia (n = 122), hemifacial spasm (n = 91) or segmental/generalized dystonia (n = 19) at a neurology outpatient clinic.
  
  
  METHODS
  Patients were switched from established abobotulinumtoxinA therapy to incobotulinumtoxinA at a ~4:1 unit ratio. Dose requirements, injection intervals, treatment efficacy, and adverse events were evaluated for a period of ≥ 1 year.
  
  
  RESULTS
  Patients were switched from abobotulinumtoxinA to incobotulinumtoxinA with a mean dose ratio of 4.07 (standard deviation (SD) 0.50). After switching, incobotulinumtoxinA dose requirements remained stable; the mean (SD) dose ratio at the end of the review period (52-219 weeks after switching) was 3.89 (SD 0.58). Injection intervals also remained stable after switching. Adverse events were injection site pain (n = 45) and bruising (n = 4). Five patients (2.0%) discontinued incobotulinumtoxinA treatment: 4 stopped receiving injections, and 1 reverted to abobotulinumtoxinA. Switching to incobotulinumtoxinA reduced the mean toxin expenditure to 76.7% of the cost of abobotulinumtoxinA.
  
  
  CONCLUSIONS
  For patients with conditions commonly treated in dystonia clinics, switching from abobotulinumtoxinA to incobotulinumtoxinA, given at equivalent doses (~4:1 unit ratio) at similar intervals, was effective, well tolerated and achieved cost savings.
authors.affiliation: Institute of Neurological Sciences, Southern General Hospital, G51 4TF Glasgow, United Kingdom. donaldgrosset@gmail.com.
authors.forename: Donald G
authors.initials: DG
authors.lastname: Grosset
authors.forename: Elaine G
authors.initials: EG
authors.lastname: Tyrrell
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Grosset
mesh_terms: D000328:Adult; D001764:Blepharospasm / Q000188:drug therapy*; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D017046:Cost Savings; D004334:Drug Administration Schedule; D004421:Dystonia / Q000188:drug therapy*; D005260:Female; D019569:Hemifacial Spasm / Q000188:drug therapy*; D006801:Humans; D007273:Injections, Intramuscular; D008297:Male; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D014103:Torticollis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA; C545476:incobotulinumtoxinA