【 文献重点摘要 】
 

Introduction

Botulinum toxin (BoNT) is the treatment of choice for many neurologic movement disorders, including blepharospasm, hemifacial spasm, and cervical dystonia. There are two serotypes approved for use by the US Food and Drug Administration: three brands of serotype A and one of serotype B. Many attempts have been made at establishing dose conversion ratios between brands and serotypes. This review focuses on the existing data comparing different formulations of the same BoNT serotypes as well as that comparing different serotypes with one another. We focus on existing data regarding switching from one formulation or serotype to another and will also discuss the issue of immunogenicity of BoNT. With this information as a foundation, recommendations on safety of switching agents are addressed.

Method

Literature review searching PubMed and Google Scholar using the search terms “switching botox”, “dosing equivalency in botox”, and “comparing botox”.

Results/conclusion

Overall, there are many studies that demonstrate the efficacy and safety of each of the brands of BoNTs used in clinical practice. However, determination of dosing equivalencies among these brands and serotypes is complex with inconsistencies among the studies. When switching from one brand to another, the clinician should be aware of these issues, and not make the assumption that such ratios exist. Tailoring the dosage of each brand of BoNT to the clinical situation is the most prudent treatment strategy rather than focusing closely on conversion factors and concerns for immunogenicity.

Keywords

botulinum toxin, BoNT, abobotulinumtoxin A, onabotulinumtoxin A, incobotulinumtoxin A, rimabotulinumtoxin B

简介

肉毒杆菌毒素(BoNT)是治疗许多神经运动障碍的首选药物，包括眼睑痉挛、面肌痉挛和颈椎肌张力障碍。美国食品和药物管理局(FDA)批准使用的血清型有两种：三种A型血清品牌和一种B型血清型。在建立品牌和血清型之间的剂量换算比方面进行了许多尝试。本综述重点介绍了相同BoNT血清型的不同配方之间的比较以及不同血清型之间的比较的现有数据。我们关注现有的关于从一种配方或血清型转换到另一种配方或血清型的数据，还将讨论BoNT的免疫原性问题。以此信息为基础，提出了关于切换代理安全的建议。

方法

检索PubMed和Google Scholar，检索词“转肉毒杆菌素”、“肉毒杆菌素剂量等效性”、“比较肉毒杆菌素”。

结果/结论

总体而言，有许多研究证明了每种品牌的BoNTs在临床应用中的有效性和安全性。然而，确定这些品牌和血清型之间的剂量当量是复杂的，研究之间存在不一致之处。当从一个品牌切换到另一个品牌时，临床医生应该意识到这些问题，而不是假设存在这样的比例。根据临床情况量身定做每种品牌BoNT的剂量是最谨慎的治疗策略，而不是密切关注转化因素和对免疫原性的担忧。

关键词

肉毒毒素，BoNT，abobotulinumtoxin A，onabotulinumtoxin A，incobotulinumtoxin A，rimabotulinumtoxin B