Comparison of different consensuses of BTXA in different countries

Summary The most international dosing guidelines on the use of botulinum toxin type A ( BTXA ) drugs support a 1:1 dose relationship between Ona BTXA and Inco BTXA and 1:2.5 between OnaBTXA and AboBTXA. However, different facial zones demonstrate different doses conversion ratios. The comparative analysis of nine consensuses on the use of Abo‐, Ona‐, and Inco BTXA in the United States, Russia, and Europe has been performed. We conducted a review of publications adopting the key words “botulinum toxin consensus,” “botulinum toxin guideline.” Information search has been carried out primarily in specialized databases ( DB ). To find the relevant RCT s and guidelines/consensuses, the following databases were used: PubMed and Medline that were screened up to May 2008. Results regarding dose ratios for Ona BTXA :Abo BTXA and Inco BTXA :Abo BTXA showed that in most cases it is characterized both by increase and by decrease compared to the ratio of 1:2.5. The mean value of dose ratios Ona BTXA :Abo BTXA adopted in the United States is 1:2.8. The ratio Inco BTXA :Abo BTXA according to international and Russian data is 1:1.9. There are some differences in clinical approach of BTXA use in certain countries. In Russia, low doses are recommended for “crow's feet” and forehead. The US consensus recommends a higher dosage to correct perioral wrinkles. Despite many years of experience in using BTXA , there is no strict international uniformity of clinical guidelines. The recommended doses for the individual areas of the face may differ in different countries. Therefore, physicians in their practice should be guided not by international consensuses, but prefer a national guidelines.