insight
← 뒤로

Challenging Interchangeability: Dynamic Dose-Response Modelling of Botulinum Toxin A Products.

Aesthetic plastic surgery 2026

Rahman E, Rao P, Sayed K, Avelar R, Webb WR, Wu WTL, Carruthers JDA

원문 ↗ DOI ↗

관련 도메인

보툴리눔독소 주사 Botulinum Toxin Injection

Abstract

[INTRODUCTION] Botulinum Neurotoxin type A (BoNT-A) formulations are used worldwide for both aesthetic and therapeutic indications, yet dose conversion between products remains based on empirical ratios that ignore pharmacodynamic variability. This study aimed to generate dynamic, time-resolved dose equivalence estimates for six FDA-approved BoNT-A formulations, onabotulinumtoxinA (ONA), abobotulinumtoxinA (ABO), incobotulinumtoxinA (INCO), daxibotulinumtoxinA (DAXI), prabotulinumtoxinA (PRABO), and letibotulinumtoxinA (LETI) and to assess how their clinical performance differs over time.

[METHODS] A hybrid, time-resolved in silico pharmacodynamic model was developed to simulate onset, peak effect, and decay kinetics using data aggregated from 49 clinical trials and regulatory submissions. Each formulation was modelled in 10,000 virtual patients to capture real-world variability in EC, maximal efficacy, and decay rate. Dose equivalence relative to 20 U of ONA was determined using two independent metrics: the area under the response curve (AURC) and time above a standardized efficacy threshold. External validation was performed against independent clinical datasets.

[RESULTS] Simulated durations ranged from 10.6 weeks (ABO) to 14.5 weeks (PRABO), matching published clinical means within ±1.2 weeks. Time-resolved conversion ratios revealed significant temporal drift: ABO increased from 2.0 to 2.7 (≈35% drift), LETI from 1.1 to 1.4 (≈27 %), while DAXI and PRABO demonstrated decreasing ratios (≈15% drift), reflecting superior persistence. Efficiency analysis ranked PRABO and DAXI highest (AURC/unit = 0.059 and 0.057), followed by ONA (0.050), INCO (0.040), LETI (0.035), and ABO (0.031). Global sensitivity analysis identified decay rate (koff) as the dominant determinant of efficacy duration (Sobol index = 0.52).

[CONCLUSION] Static dose conversion ratios fail to represent the dynamic pharmacodynamic behaviour of BoNT-A formulations. This simulation-based, data-driven approach reproduces clinical outcomes with high fidelity and provides a robust framework for effect-based dose equivalence, improving precision in product substitution and individualized treatment planning.

[LEVEL OF EVIDENCE IV] This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

추출된 의학 개체 (NER)

유형영어 표현한국어 / 풀이UMLS CUI출처등장
시술 botulinum toxin 보툴리눔독소 주사 dict 1
해부 DAXI → daxibotulinumtoxinA scispacy 1
약물 incobotulinumtoxinA C2930113
incobotulinumtoxinA
 scispacy 1
약물 PRABO → prabotulinumtoxinA C4762545
PRABOTULINUMTOXINA
 scispacy 1
약물 [INTRODUCTION] Botulinum Neurotoxin type A scispacy 1
약물 BoNT-A → Botulinum Neurotoxin type A scispacy 1
약물 onabotulinumtoxinA scispacy 1
약물 abobotulinumtoxinA scispacy 1
질환 ONA → onabotulinumtoxinA C2719767
onabotulinumtoxinA
 scispacy 1
질환 INCO → incobotulinumtoxinA scispacy 1
기타 Botulinum Toxin A scispacy 1
기타 patients scispacy 1
기타 ABO → abobotulinumtoxinA scispacy 1
기타 BoNT-A formulations scispacy 1

📑 인용 관계

이 논문이 참조한 문헌 50

외부 PMID 30건 (DB 미수집)

🔗 함께 등장하는 도메인

이 논문이 속한 카테고리와 같은 논문에서 자주 함께 다뤄지는 카테고리들

필러 주입술 (21) 안검성형술 (14) 유방 (10) 안면거상술 (10) 지방흡입 (9) 코성형술 (8) 히알루론산 (7) 유방성형술 (6)

관련 논문