Estudo comparativo das marcas de toxina botulínica: uma revisão de literatura

Botulinum toxin type A (BoNT/A) is widely used in dentistry and orofacial harmonization for both therapeutic and aesthetic purposes. However, the different commercially available formulations have specific characteristics related to their composition, complexing proteins, excipients, biological potency, immunogenicity, and duration of clinical effects. This study aims to compare the main commercial formulations of botulinum toxin type A described in the scientific literature, considering their pharmacological characteristics, efficacy, safety, and clinical relevance. This is an exploratory and descriptive literature review employing a qualitative approach and comparative analysis. The investigation encompasses publications related to the Botox®, Dysport®, Xeomin®, Prosigne®, Botulift®, and Nabota® formulations, addressing aspects such as the non-interchangeability of potency units, the influence of injection technique, the potential development of neutralizing antibodies, and product selection criteria. The literature analyzed indicates that, although these formulations share the same active ingredient, their pharmaceutical and pharmacological differences prevent them from being considered automatically equivalent. Notably, the absence of complexing proteins in certain formulations, such as incobotulinumtoxinA, represents a relevant characteristic regarding immunogenic potential but does not establish universal clinical superiority. It is concluded that the choice of formulation should be individualized, based on scientific evidence, and guided by the clinical indication, patient characteristics, safety, professional experience, and cost-effectiveness. Further independent, long-term comparative studies are needed to clarify the differences among the available formulations.