Ventura Patients Ask, "Botox or Dysport?"

Botox finally has competition in the battle against wrinkles.  Dysport has been clinically tested and utilized in Europe and South America with promising results.  (By the way, Dysport may end up being renamed Reloxin; the marketing is still being fine-tuned.)

 

After reviewing the available literature on Dysport, this much can be said so far:

 

 

1) Dysport and Botox have similar mechanisms of action:  neuromuscular blocking toxin.

 

2) Dysport has less of a protein load than Botox.  Clinically, this means that Dysport will probably result in the formation of fewer antibodies against it.  Antibodies are what our bodies use to detect and destroy foreign proteins.  Hence, the assumption is, if fewer antibodies being formed, the clinical effects of Dysport should last longer than those of Botox(?).  That being said, some clinical trials indicate that Botox has longer lasting results; of course, those studies were sponsored by Allergan (the makers of Botox).

 

3) In at least a couple of clinical studies, Dysport seemed to "spread more" after injection.  If this is true, increased spreading could be both a good thing and a bad thing.  It is good when large areas need injections (such as the forehead for wrinkles, or the underarms for sweating); more spread, fewer injections required, and less likelihood of potential discomfort, swelling, or bruising.  The increased spreading is a bad thing when an injector wants to do extremely fine work.  Only an experienced injector who has a good understanding of more complex musculature (around the eyes, between the eyebrows) would be able to avoid affecting “good muscles” and prevent untoward side effects (blurry vision, droopy eyebrows).

 

4) A unit of Dysport does not equal a unit of Botox.  Some studies show that 20 units of Dysport didn’t provide as much wrinkle reduction at the glabella (the area between the eyebrows) as 20 units of Botox.  However, the comparison wasn’t fair.  A unit of Botox is probably equivalent to 2, 3, 4, or even 5 units of Dysport.  The optimum dosages for Dysport will need to be determined.

 

5) At this stage no significant "red flags" have been raised about the safety of Dysport.  Of specific concern, allergies and infections have not been seen to a clinically significant degree.

 

6) I still haven’t seen the pricing for Dysport.  I hope that it will be cheaper.  In the United Kingdom, a 500-unit vial of Dysport costs about 45% less than a 100-unit vial of Botox.

 

 

As always competition is a good thing.  The emergence of an alternative drug to Botox should spur on pricing competition that will benefit both patients and physicians alike.  Also new research and development is already under way to provide the next "bigger and better" product.  (Mentor, now owned by Johnson & Johnson will be releasing PurTox soon….)