Beyond Botox: Other Neurotoxins—What Are Similarities and Differences?

This chapter describes the pharmacological and clinical characteristics of six botulinum toxins—Botox, Xeomin, Dysport, Myobloc, Jeuveau and Dixxify—currently approved by FDA for use in the US. Two other unapproved, but widely used, botulinum toxins in Asia, Prosigne and Meditox are also briefly discussed. In addition, a brief account on the structure of clinical trials and definition of study phases, I, II, III, IV as it pertains to clinical investigations in the field of toxicology is also provided. The classification of clinical studies based on their quality—class I to IV and their level of study efficacy—A, B, C, U—are described using the guidelines provided by the Assessment and Therapeutics Subcommittee of the American Academy of Neurology.