Jee Hye Lee; Su Kyung Jung; Ji Sun Baik; Suk Woo Yang

doi:10.3341/jkos.2015.56.6.811

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Lee, Jung, Baik, and Yang: Comparative Study of Hugel-tox® versus Botox® for the Treatment of Essential Blepharospasm

Original Article

J Korean Ophthalmol Soc 2015;56(6):811-814.

Published online: 7 September 2015

DOI: https://doi.org/10.3341/jkos.2015.56.6.811

Comparative Study of Hugel-tox^® versus Botox^® for the Treatment of Essential Blepharospasm

Jee Hye Lee, MD, Su Kyung Jung, MD, Ji Sun Baik, MD, Suk Woo Yang, MD, PhD

Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Address reprint requests to Suk Woo Yang, MD, PhD Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea, Tel: 82-2-2258-2846, Fax: 82-2-599-7405 E-mail: yswoph@catholic.ac.kr

Received 29 August 201417 December 2014 Accepted 23 April 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare clinical efficacy and duration of Hugel-tox^Ⓡ (also known as Botulax^Ⓡ) and Botox^Ⓡ for the treatment of essential blepharospasm.

Methods

A total of 48 patients who were injected with Hugel-tox^Ⓡ (17 females, 7 males) or Botox^Ⓡ (18 females, 6 males) from February 2013 to October 2013 were enrolled in the present study. Changes in eyelid closing force and Scott grade before and after injection were analyzed. Adverse events were also evaluated.

Results

There were no significant differences between the Hugel-tox^Ⓡ and Botox^Ⓡ groups in clinical efficacy and duration. Before and after injection, changes in Scott grade (Hugel-tox^Ⓡ: -1.17 ± 0.70, Botox^Ⓡ: -1.21 ± 0.72, p = 0.840), changes in eyelid closing force (Hugel-tox^Ⓡ: -1.38 ± 0.58, Botox^Ⓡ: -1.17 ± 0.56, p = 0.212) and duration (Hugel-tox^®: 116.08 ± 22.12 days, Botox^®: 126.92 ± 38.94 days, p = 0.242) were shown. No serious adverse events were found in either group.

Conclusions

Hugel-tox^® showed nearly equal efficacy and duration compared with Botox^®.

Keywords: Botox, Essential blepharospasm, Hugel-tox

References

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Table 1.

Scoring definition for eyelid closing force

Grade	Definition
1	Flaccid
2	Able to resist minimum resistance
3	Able to resist moderate resistance
4	Normal strength

Table 2.

Scoring definition for Scott grade

Grade	Definition
0	No spasm
1	Mild spasm at stimulation only
2	Visible spasm with no disability
3	Apparent spasm, mild disability
4	High disability

Table 3.

Numbers of patients with clinical adverse effects

	Hugel-tox®	Botox®
Lagophthalmos	10	8
Ptosis	1	1
Ecchymosis at the injection site	2	2
Lid edema	1	1
Blurred vision	2	1

Table 4.

Demographics and clinical characteristics of the patients

	Hugel-tox® (n = 24)	Botox® (n = 24)	p-value
Age (years)	64.00 ± 7.47	64.54 ± 9.73	0.830^*
Female:male (n)	17:7	18:6	0.755^†
Duration of blepharospasm (years)	3.33 ± 2.59	4.80 ± 3.80	0.104^*
Number of previous botulinum injection (n)	4.08 ± 4.42	6.13 ± 5.42	0.160^*

Values are presented as mean ± SD unless otherwise indicated.

^* t-test were used for statistical analysis

^† χ² test were used for statistical analysis.

Table 5.

Comparison of Scott grade between the Hugel-tox® and Botox® treatment groups

	Before injection	After injection	Difference
Hugel-tox®	2.88 ± 0.54	1.71 ± 0.62	-1.17 ± 0.70
Botox®	3.00 ± 0.66	1.79 ± 0.59	-1.21 ± 0.72
p-value	0.475	0.636	0.840

Values are presented as mean ± SD unless otherwise indicated. t-test was used for statistical analysis.

Table 6.

Comparison of eyelid closure force between the Hugel-tox® and Botox® treatment groups

	Before injection	After injection	Difference
Hugel-tox®	3.17 ± 0.64	1.79 ± 0.51	-1.38 ± 0.58
Botox®	3.08 ± 0.71	1.91 ± 0.58	-1.17 ± 0.56
p-value	0.672	0.433	0.212

Values are presented as mean ± SD unless otherwise indicated. t-test was used for statistical analysis.

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