Disclosures: Sudhakar Raja Subramaniam, MPharm, PhD: Allergan Aesthetics, an AbbVie Company, (Products/Services: Yes) (Employment)

Objective: OnabotulinumtoxinA (onabotA), a botulinum toxin type A (BoNT/A) protein complex containing nontoxic neurotoxin-associated proteins (NAPs), is approved for migraine and has shown anti-inflammatory and analgesic properties in numerous animal pain models and clinical pain disorders. Herein, we compared the anti-inflammatory and analgesic efficacy of onabotA with purified 150-kDa BoNT/A toxin (BoNT/A-150) in several pain models.

Design: Analysis of ED50, ED90, and ED105 values generated from rat Digit Abduction Score (DAS) assay dose-response curves was used to establish the equi-efficacious doses of onabotA and BoNT/A-150 on a motor indication.Setting : Not applicableParticipants : Not applicable

Interventions: Not applicable

Main Outcome Measures: Toxin efficacy was evaluated in 3 inflammatory pain rat models (formalin-induced nociceptive behavior, Complete Freund’s Adjuvant [CFA]-induced acute paw inflammation, and monoiodoacetate [MIA]-induced chronic joint inflammation) and in 1 neuropathic pain model (spared nerve injury [SNI]).

Results: Maximum equi-efficacious doses of onabotA and BoNT/A-150 in the DAS assay were determined as 15 U/kg and 0.1 ng/kg (≈17 U/kg), respectively, and these doses were used for testing in the pain models. In the formalin-induced pain model, onabotA displayed a marked 47% reduction in nociceptive behavior, whereas BoNT/A-150 showed a 35% decrease. In the CFA pain model, both onabotA and BoNT/A reduced CFA-induced paw inflammation equally. In the MIA-induced pain model, onabotA significantly diminished knee joint inflammation, whereas BoNT/A-150 showed only a trend in reduction. OnabotA and BoNT/A-150 improved MIA-induced dynamic weight-bearing deficit by 50% and 38%, respectively. In the SNI neuropathic pain model, only onabotA evoked a significant reduction in mechanical allodynia.Conclusions: OnabotA displayed greater anti-inflammatory and analgesic efficacy compared with purified BoNT/A-150 in models of inflammatory and neuropathic pain, suggesting that the NAPs present in onabotA may play a vital role in enhancing the antinociceptive properties of this toxin.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/onabotulinumtoxina-exhibits-greater-efficacy-compared-to-purified-botulinum-neurotoxin-a-bont-a-150-kda-in-peripheral-pain-models/