What is Disport (Botulinum toxin type A)?

What is Disport?

Disport (abobotulinumtoxinA) is a pharmaceutical formulation of botulinum neurotoxin type A used for therapeutic and cosmetic purposes that works by blocking acetylcholine release at neuromuscular junctions, causing temporary muscle paralysis. 1

Mechanism of Action

Disport functions through four sequential steps that result in muscle relaxation 1:

• Binding: The neurotoxin binds to peripheral cholinergic nerve terminals at the neuromuscular junction 1
• Internalization: The toxin complex is taken into the nerve cell 1
• Translocation: The active component moves across cellular membranes 1
• Proteolysis: The toxin cleaves target proteins that normally allow acetylcholine release, preventing neurotransmitter release and causing flaccid paralysis of the targeted muscle 2, 1

Product Characteristics and Manufacturing

Disport is manufactured through a proprietary process that distinguishes it from other botulinum toxin type A products 1, 3:

• Production strain: Derived from Clostridium botulinum type A, strain ATCC 3502 (Hall strain), using unique isolation and purification methods including column chromatography 1, 3
• Neurotoxin content: Contains approximately 0.65 ng of the 150 kD botulinum neurotoxin per 100 units 3
• Specific potency: Has a specific neurotoxin activity of 154 units/ng 3
• Batch consistency: Demonstrates high degree of long-term consistency across batches for potency, protein composition, and endopeptidase activity 1

Clinical Applications

Disport has been used successfully for nearly 20 years in Europe and is now FDA-approved in the United States for various therapeutic and aesthetic indications 1, 4:

Therapeutic Uses

• Cervical dystonia: Mean doses range from 387 to 530 units 5
• Upper limb spasticity: Mean doses range from 508 to 773 units 5
• Lower limb spasticity: Mean doses range from 600 to 832 units 5
• Pediatric cerebral palsy: Mean doses range from 375 to 700 units 5
• Blepharospasm/hemifacial spasm: Mean doses range from 54 to 213 units 5

Aesthetic Uses

• Glabellar rhytids (frown lines): FDA-approved for cosmetic reduction of dynamic facial wrinkles 4
• The paralytic effect relaxes underlying muscles, reducing overlying skin wrinkles 4

Critical Safety Considerations

Non-Interchangeability Warning

Disport units are NOT interchangeable with other botulinum toxin type A products (such as Botox/onabotulinumtoxinA or Xeomin/incobotulinumtoxinA). 4 Each product has different:

• Manufacturing processes 1
• Specific potencies 3
• Dosing requirements 4

Common Adverse Events by Indication

Physicians should monitor for indication-specific adverse events 5:

• Cervical dystonia: Dysphagia (difficulty swallowing) 5
• Upper limb spasticity: Arm muscle weakness 5
• Lower limb spasticity: Leg muscle weakness 5
• Blepharospasm: Ptosis (eyelid drooping) 5

High-Risk Populations

Patients with pre-existing neuromuscular disorders face increased risk of exaggerated muscle weakness and systemic effects even at standard doses 6:

• Myasthenia gravis 6
• Lambert-Eaton syndrome 6
• Amyotrophic lateral sclerosis (ALS) 6
• Other motor neuropathy disorders 6

Serious Systemic Effects

In severe cases, botulinum toxin can cause botulism-like symptoms 7, 6:

• Cranial nerve palsies followed by descending symmetric flaccid paralysis 6
• Respiratory compromise requiring mechanical ventilation if respiratory muscles are affected 6
• Anaphylaxis occurs in less than 2% of patients, requiring immediate epinephrine and antihistamines 6

Recovery Timeline

Recovery from muscle paralysis occurs gradually as new nerve terminals sprout 2, 6:

• Duration: Takes weeks to months for full recovery 2, 6
• Mechanism: New nerve terminal growth allows restoration of normal muscle function 2

Standard Reconstitution

The most commonly used reconstitution volume in clinical practice is 2.5 mL per 500 unit vial across all therapeutic indications 5.