Corneoplastic Department, Queen Victoria Hospital, East Grinstead, UK.
Clin Exp Ophthalmol. 2020 Dec;48(9):1146-1151. doi: 10.1111/ceo.13829. Epub 2020 Aug 14.
When making a cost-saving it is important to ensure there is no loss of efficacy.
Clinical effectiveness and efficiency of incobotulinumtoxinA compared to onabotulinumtoxinA in facial dystonia is unclear. Our aim is to evaluate switching from onabotulinumtoxinA to incobotulinumtoxinA in the treatment of essential blepharospasm (EB), hemifacial spasm (HFS) and aberrant facial nerve regeneration (AFR).
A retrospective study of a prospective, single-masked switchover audit from onabotulinumtoxinA to incobotulinumtoxinA.
Twenty essential EB, 12 HFS and six AFR patients.
A switchover from stable onabotulinumtoxinA to incobotulinumtoxinA using a 1:1 unit ratio and contemporaneous efficacy measures. Two nurse injectors performed the injections over a period of 6 years. Each masked patient received three onabotulinumtoxinA and three incobotulinumtoxinA over a minimum of 2 years.
At each visit, a blepharospasm disability score (BDS), Jankovic score (JS), subjective improvement (SI), duration of maximum effect (DME) and complications were recorded. A cost comparison per unit dose was made.
Twenty EB, 12 HFS and six AFR received 114 onabotulinumtoxinA and 114 incobotulinumtoxinA treatments. Both brands had similar efficacy, but SI (P < .01) and DME (P < .05) were higher in the HFS group with incobotulinumtoxinA. Complications included bruising (two onabotulinumtoxinA, one incobotulinumtoxinA) and ptosis (three onabotulinumtoxinA, zero incobotulinumtoxinA). OnabotulinumtoxinA was 33% pricier.
Switching from onabotulinumtoxinA to incobotulinumtoxinA did not result in an inferior outcome for the treatment of facial dystonia and led to a cost-saving for the department.
在进行节省成本的措施时，确保不会降低疗效非常重要。
在面部肌张力障碍中，与肉毒毒素 A 相比，利鲁唑的临床疗效和效率尚不清楚。我们的目的是评估从肉毒毒素 A 转换为利鲁唑在治疗特发性眼睑痉挛（EB）、半面痉挛（HFS）和异常面神经再生（AFR）中的效果。
一项前瞻性、单盲转换审计的回顾性研究，从肉毒毒素 A 转换为利鲁唑。
20 名特发性 EB、12 名 HFS 和 6 名 AFR 患者。
使用 1:1 单位比例和同期疗效指标，从稳定的肉毒毒素 A 转换为利鲁唑。两名护士注射师在 6 年内进行了注射。每位接受单盲治疗的患者在至少 2 年内接受了 3 次肉毒毒素 A 和 3 次利鲁唑治疗。
每次就诊时，记录眼睑痉挛残疾评分（BDS）、詹科夫斯基评分（JS）、主观改善（SI）、最大效果持续时间（DME）和并发症。对单位剂量进行了成本比较。
20 名 EB、12 名 HFS 和 6 名 AFR 患者接受了 114 次肉毒毒素 A 和 114 次利鲁唑治疗。两种药物的疗效相似，但 HFS 患者的 SI（P <.01）和 DME（P <.05）更高。并发症包括瘀斑（肉毒毒素 A 2 例，利鲁唑 1 例）和上睑下垂（肉毒毒素 A 3 例，利鲁唑 0 例）。肉毒毒素 A 贵 33%。
从肉毒毒素 A 转换为利鲁唑不会降低治疗面部肌张力障碍的效果，并为科室节省了成本。
