Comparison of preferences between onabotulinumtoxinA (Botox) and incobotulinumtoxinA (Xeomin) in the treatment of benign essential blepharospasm.

PURPOSE: To evaluate subjective outcomes and preferences in patients with benign essential blepharospasm (BEB) treated with both onabotulinumtoxinA (Botox) and incobotulinumtoxinA (Xeomin).

METHODS: An institutional review board approved retrospective review of 128 patients treated with onabotulinumtoxinA for BEB by 1 author (J.B.H.). Fifty of these patients were switched to incobotulinumtoxinA as an alternate drug. At scheduled follow up, patients decided to continue with incobotulinumtoxinA or switch to onabotulinumtoxinA. Patient preferences regarding treatment with onabotulinumtoxinA versus incobotulinumtoxinA were recorded. The preference groups were analyzed using unpaired Student t test, with statistical significance set at p < 0.05.

RESULTS: Of the 50 incobotulinumtoxinA patients, the mean age was 64.9 years; 39 (78%) were women and 11 (22%) were men. In all, 26 (52%) preferred incobotulinumtoxinA and 24 (48%) preferred onabotulinumtoxinA. Most frequently, those who preferred incobotulinumtoxinA believed that it was "more effective" (N = 10, 29%), whereas those who preferred onabotulinumtoxinA concluded that it had a "longer duration" (N = 11, 37%). The mean treatment interval was 13.0 weeks (standard deviation [SD] = 6.39) in those who preferred onabotulinumtoxinA, whereas it was 10.2 weeks (SD = 2.15) in those who preferred incobotulinumtoxinA (p = 0.017). There was no statistical difference when comparing mean disease duration, number of total treatments, and number of units/treatment between the 2 preference groups.

CONCLUSIONS: This study demonstrates that patients who prefer incobotulinumtoxinA over onabotulinumtoxinA had a statistically significant shorter treatment interval. In addition, those who preferred incobotulinumtoxinA thought it was more effective, whereas those patients who preferred onabotulinumtoxinA thought it had a longer duration. This information can be used when counseling both newly diagnosed and long-standing BEB patients regarding their therapeutic options.