肉毒杆菌素与丽舒妥治疗原发性腋窝多汗症的同患者前瞻性比较及文献综述
Same-patient prospective comparison of Botox versus Dysport for the treatment of primary axillary hyperhidrosis and review of literature.
作者信息
Vergilis-Kalner Irene J
机构信息
Robert Wood Johnson Medical School, University of Medicine & Dentistry of New Jersey, NJ, USA.
出版信息
J Drugs Dermatol. 2011 Sep;10(9):1013-5.
BACKGROUND
Botulinum toxin (BTX) is an effective, FDA-approved treatment for primary axillary hyperhidrosis. In this prospective study, two non-bioequivalent toxins: Botox (Allergan, Irvine, CA, USA) and Dysport (Ipsen Ltd., Slough, Berkshire, UK) were compared for the treatment of primary axillary hyperhidrosis.
OBJECTIVE
The objective was to compare the injection site pain, efficacy, safety and tolerability of Botox versus Dysport in the treatment of primary axillary hyperhidrosis using a conversion factor of 1:3, respectively.
METHODS
A patient with primary axillary hyperhidrosis was treated with 100 units of Botox into the right axilla and 300 units of Dysport into the left axilla. Patient was blinded as to which axilla received treatment and with which of the two toxins. Pain at the injection site of these two toxins was evaluated. The patient was subsequently followed for the next 10 months to evaluate the difference in these two toxins in regards to side effects, time to the onset of reduction of sweating and the duration of action of these two toxins.
RESULTS
Significant difference was observed in the onset of action of these two toxins, with dramatic reduction in sweating being observed after one week of injection with Botox and after two weeks of injection with Dysport. At the two-week time point, similar success in eliminating sweating was reported in both axilla. The duration of benefits also differed between the two toxins, with elimination of sweating in the Dysport-treated axilla lasting six months and, in the Botox-treated axilla, nine months. No other differences were observed between these two toxins.
CONCLUSIONS
Both Botox and Dysport led to a similar perceived reduction of sweating in the treatment of primary axillary hyperhidrosis when a conversion factor of 1:3 was used. However, Botox treatment resulted in a quicker onset of action and longer duration of benefits.
背景
肉毒杆菌毒素（BTX）是一种经美国食品药品监督管理局（FDA）批准用于治疗原发性腋窝多汗症的有效药物。在这项前瞻性研究中，对两种非生物等效毒素：保妥适（美国加利福尼亚州欧文市艾尔建公司）和丽舒妥（英国伯克郡斯劳市益普生有限公司）治疗原发性腋窝多汗症的效果进行了比较。
目的
目的是分别使用1:3的换算系数，比较保妥适和丽舒妥治疗原发性腋窝多汗症时的注射部位疼痛、疗效、安全性和耐受性。
方法
一名原发性腋窝多汗症患者，右侧腋窝注射100单位保妥适，左侧腋窝注射300单位丽舒妥。患者对哪侧腋窝接受了哪种毒素治疗不知情。评估这两种毒素注射部位的疼痛情况。随后对患者进行了为期10个月的随访，以评估这两种毒素在副作用、出汗减少开始时间和作用持续时间方面的差异。
结果
观察到这两种毒素的起效时间有显著差异，保妥适注射一周后出汗显著减少，丽舒妥注射两周后出汗显著减少。在两周时间点，两侧腋窝在消除出汗方面取得了相似的效果。两种毒素的获益持续时间也有所不同，丽舒妥治疗的腋窝出汗消除持续6个月，保妥适治疗的腋窝出汗消除持续9个月。这两种毒素之间未观察到其他差异。
结论
当使用1:3的换算系数时，保妥适和丽舒妥在治疗原发性腋窝多汗症时导致的出汗减少感觉相似。然而，保妥适治疗起效更快，获益持续时间更长。
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