Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada.
Dermatol Surg. 2013 Mar;39(3 Pt 2):493-509. doi: 10.1111/dsu.12147.
The U.S. Food and Drug Administration has approved four distinct formulations of botulinum toxin (BoNT) serotypes A and B (BoNTA and BoNTB) for medical use. These four products are indicated for many medical applications, but the three BoNTA formulations are the most widely used worldwide and are the only products approved for aesthetic use. The latest approval of a BoNTA with no complexing proteins (incobotulinumtoxinA) necessitates a review and discussion of differences between available formulations and the effect that these differences may have on clinical practice.
To review the history, science, safety information, and current and emerging applications of BoNT in clinical and cosmetic practice and to compare commercially available BoNTA formulations.
Publications, clinical trials, and author experience were used as a basis for an up-to-date review of BoNT and its use in human medicine. The similarities and differences between formulations are presented, and diffusion, spread, equivalency ratios, stability, and storage are discussed.
Each commercial formulation has unique characteristics that may influence its use in aesthetic medicine. Familiarity with the similarities and differences between products will aid physicians in making patient care decisions.
New formulations, emerging uses, and continued research into the science and uses of BoNTA will lead to increasingly refined therapeutic approaches and applications. Continued education is important for physicians to optimize use of the agent according to the most current evidence and approaches.
美国食品和药物管理局已批准四种不同的肉毒毒素（BoNT）血清型 A 和 B（BoNTA 和 BoNTB）用于医疗用途。这四种产品适用于许多医疗应用，但三种 BoNTA 制剂在全球范围内应用最广泛，也是唯一批准用于美容用途的产品。最新批准的一种不含复合蛋白的 BoNTA（incobotulinumtoxinA）需要对现有制剂之间的差异以及这些差异可能对临床实践产生的影响进行审查和讨论。
回顾 BoNT 在临床和美容实践中的历史、科学、安全性信息以及当前和新兴的应用，并比较市售的 BoNTA 制剂。
使用出版物、临床试验和作者经验作为最新 BoNT 及其在人类医学中应用的综述基础。介绍了制剂之间的异同，并讨论了扩散、传播、等效比、稳定性和储存。
每个商业制剂都有独特的特性，可能会影响其在美容医学中的应用。熟悉产品之间的异同将有助于医生做出患者护理决策。
新制剂、新用途以及对 BoNTA 的科学和用途的持续研究将导致治疗方法和应用的不断改进。医生需要不断接受教育，根据最新的证据和方法优化该药物的使用。
