New competition for BOTOX®
Look out BOTOX®! Your competition for wrinkle reduction in the United States has finally arrived. After years of clinical trials in the U.S. and many more years of clinical use and experience overseas, Dysport® has recently received FDA approval.
For the past 7 years, BOTOX® (botulinum toxin type A, Allergan, Inc.) has been the only choice for injectable wrinkle correction of frown lines around the eyes and forehead. That changed last month when Dysport® (botulinum toxin type A-hemagglutinin complex, Medicis) received FDA approval in the United States.
How does Dysport® work?
BOTOX® and Dysport® are injectable medications that are comprised of proteins derived from the bacteria Clostridium botulinum that produces botulinum toxin. These proteins are absorbed into the neuromuscular junction and cause a local paralysis at the site of the injection. Many of the lines and wrinkles that form around the eyes and on the forehead are caused by muscle action on the skin. Reducing this muscle action by injecting this protein is extremely effective at reducing these fine lines and wrinkles for a certain length of time.
Is Dysport® more effective than BOTOX®?
There have been mixed reports regarding the clinical response to Dysport® versus BOTOX®. It is understood that Dysport® has about one-third the potency of BOTOX® and therefore requires more of it to be delivered to the site of action. However, many practitioners have noticed that when using a similar concentration of Dysport®, there is a longer duration of action. Some clinicians have noticed that Dysport® may last up to 1 month longer than BOTOX®.
This may, however, come at a price. There have been reports that suggest a tendency for the medication to travel farther from the injection site when compared to its competitor. This may be good when treating forehead lines, where a broader treatment is needed. But it can be a detriment when trying to treat specific areas around the eyes. If the product travels too far in these areas, there may be a higher incidence of eyebrow ptosis or droop. However, the incidence of eyebrow droop is no higher than BOTOX® in large clinical trials, and, in fact, may be a little lower!
What is the difference in price?
While competition in the market place is generally good for reducing prices, it is unlikely we will see a drop in prices when the use of Dysport® becomes more widespread. At this time, it does not look like the cost of Dysport® to the physician will be much less than the cost of BOTOX®. The cost to the patient remains to be seen.
When will Dysport® become available?
We can expect Medicis, the manufacturer of Dysport®, to start making this medication widely available to cosmetic surgeons and dermatologists in the fall.
