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Three botulinum neuromodulators efficacious in facial synkinesis

AbobotulinumtoxinA, onabotulinumtoxinA and incobotulinumtoxinA were associated with similar efficacy in facial synkinesis within 4 weeks of treatment.

The current single-blind randomized clinical trial included 28 patients treated at a single center in the United States. Eligible participants assessed their own severity of synkinesis using the Synkinesis Assessment Questionnaire at 1, 2 and 4 weeks after treatment.

Data are included for 38 treatments, and six patients enrolled in the study more than once. Fifteen onabotulinumtoxinA, 13 abobotulinumtoxinA and 10 incobotulinumtoxinA courses underwent assessment.

OnabotulinumtoxinA was associated with a 41% (standard deviation [SD], 31%) improvement in the questionnaire score at 4 weeks compared with a 42% (SD, 20%) improvement for abobotulinumtoxinA and a 17% (SD, 18%) improvement for incobotulinumtoxinA at the same time point.

At week 1, 42% of patients in the onabotulinumtoxinA arm, 45% in the abobotulinumtoxinA arm and 26% in the incobotulinumtoxinA arm showed improvement on the questionnaire (P = .19). Similarly, the improvements at week 2 were 43% of patients in the onabotulinumtoxinA arm, 46% of those treated with abobotulinumtoxinA and 28% of those treated with incobotulinumtoxinA (P = .20).

No significant difference was reported for mean improvement in Synkinesis Assessment Questionnaire score between baseline and 4 weeks for abobotulinumtoxinA (30 points) compared with incobotulinumtoxinA (12 points; P = .11). However, there was a significant difference in mean total questionnaire score between abobotulinumtoxinA (40.34) and incobotulinumtoxinA (58; P = .02).

“AbobotulinumtoxinA had similar efficacy to onabotulinumtoxinA and incobotulinumtoxinA for the management of facial synkinesis up to 4 weeks after treatment,” the researchers concluded. They added that the incobotulinumtoxinA may have had less of an effect than onabotulinumtoxinA because it has a shorter duration of action. “Shorter intervals between treatments or larger doses may be required when using incobotulinumtoxinA treatment for facial synkinesis.” – by Rob Volansky

Disclosures: The authors report no relevant financial disclosures.