Vol 55, No 2 (2021)
Review Article
Published online: 2021-04-02

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Botulinum toxin type-A preparations are not the same medications — basic science (Part 1)

Halina Car1, Andrzej Bogucki2, Marcin Bonikowski3, Małgorzata Dec-Ćwiek4, Artur Drużdż5, Dariusz Koziorowski6, Monika Rudzińska-Bar7, Iwona Sarzyńska-Długosz8, Jarosław Sławek9
Pubmed: 33797747
Neurol Neurochir Pol 2021;55(2):133-140.


Botulinum neurotoxin type A (BoNT/A) formulations are widely used in clinical practice. Although they share a common mechanism of action resulting in presynaptic block in acetylocholine release, their structure and pharmacological properties demonstrate some similarities and many differences. Bioequivalence has been discussed since the onset of the clinical use of BoNT/A. In this review, we provide an update on the studies and compare the molecular structure, mechanisms of action, diffusion and spread, as well as immunogenicity and dose equivalence of onabotulinumtoxinA, abobotulinumtoxinA and incobotulinumtoxinA.

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