Xeomin is a pure botulinum toxin type A (BTX-A) preparation licensed for the symptomatic management of blepharospasm and cervical dystonia of a predominantly rotational form (spasmodic torticollis) in adults.

The lack of protein complexes in the Xeomin preparation is suggested to be associated with a reduced risk of immunogenicity and reduced number of secondary non-responders. 

Xeomin is the fourth BTX-A preparation to be licensed in the UK.

The botulinum toxin units used in each preparation are specific to that product and are not interchangeable.

Xeomin is the only BTX-A preparation that can be stored at room temperature, which reduces the risk of product wastage and removes the need for cold chain storage and distribution between pharmacy and clinics.

Two phase III studies have compared Xeomin to Botox, for the treatment of blepharospasm and spasmodic torticollis.

What these two studies show is that a single dose of Xeomin is as effective as a single dose of Botox in treating blepharospasm and spasmodic torticollis, in patients who have already shown response to Botox: no treatment-naïve patients were enrolled. 

In both of these studies a single dose of BTX-A was administered.  This provides no evidence of non-response or development of immunogenicity.  Long-term clinical studies with antibody testing are required to confirm these claims.

Xeomin has been compared with placebo in a single dose efficacy and safety study in patients with upper-limb spasticity post-stroke. Xeomin is not yet licensed for this indication.  Xeomin treatment was more effective than placebo in reducing muscle tone in the flexors of the wrist, forearm, elbow and thumb, and improvement functional ability.