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Treatment of cervical dystonia with abo- and onabotulinumtoxinA: long-term safety and efficacy in daily clinical practice.
J Neurol 2019; 266(8):1879-1886JN

Abstract

INTRODUCTION

Treatment with botulinum toxin A is the evidence-based first-line therapy of cervical dystonia. The aim of this study was to analyze long-term data of the most commonly used products concerning safety and efficacy in a big cohort over decades.

METHODS

We retrospectively analyzed the treatment data of all cervical dystonia patients in our outpatient clinic having at least three treatment sessions with current onabotulinumtoxinA or abobotulinumtoxinA. The observation period was up to 17 years for onabotulinumtoxinA and 27 years for abobotulinumtoxinA. We report on safety and efficacy, comparing parameters such as dose, treatment intervals, side effects, occurrence and reasons of primary or secondary non-response.

RESULTS

We analyzed a total of 2592 and 6660 treatment sessions in 135 patients with onabotulinumtoxinA, 209 with abobotulinumtoxinA and 10 having received both preparations. We found a moderate increase of dosage in the first years which was succeeded by a stable mean dose (138 and 663 mouse units, respectively) and stable injection intervals from the beginning. The most frequent side effects were mild dysphagia (2/6%), muscle weakness (2/6%) and pain (2/2%). Reasons for therapy discontinuation were change to a nearby doctor, age, other diseases, spontaneous improvement, side effects or possible treatment failure. Of all patients, only two tested positive for neutralizing antibodies against botulinum toxin A.

CONCLUSION

We show that treatment of cervical dystonia with the two most frequently used botulinum toxin A preparations is a safe and effective therapy even over a long treatment duration of up to 27 years.

Authors+Show Affiliations

Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany.Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany.Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany.Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany.Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany. Institute for Neurogenomics, Helmholtz Center Munich, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany.Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany. Department of Neurology and Neurologic Rehabilitation, Asklepios Stadtklinik Bad Tölz, Schützenstrasse 15, 83646, Bad Tölz, Germany.Department of Neurology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany. bernhard.haslinger@tum.de.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31049731

Citation

Jochim, Angela, et al. "Treatment of Cervical Dystonia With Abo- and onabotulinumtoxinA: Long-term Safety and Efficacy in Daily Clinical Practice." Journal of Neurology, vol. 266, no. 8, 2019, pp. 1879-1886.
Jochim A, Meindl T, Mantel T, et al. Treatment of cervical dystonia with abo- and onabotulinumtoxinA: long-term safety and efficacy in daily clinical practice. J Neurol. 2019;266(8):1879-1886.
Jochim, A., Meindl, T., Mantel, T., Zwirner, S., Zech, M., Castrop, F., & Haslinger, B. (2019). Treatment of cervical dystonia with abo- and onabotulinumtoxinA: long-term safety and efficacy in daily clinical practice. Journal of Neurology, 266(8), pp. 1879-1886. doi:10.1007/s00415-019-09349-2.
Jochim A, et al. Treatment of Cervical Dystonia With Abo- and onabotulinumtoxinA: Long-term Safety and Efficacy in Daily Clinical Practice. J Neurol. 2019;266(8):1879-1886. PubMed PMID: 31049731.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of cervical dystonia with abo- and onabotulinumtoxinA: long-term safety and efficacy in daily clinical practice. AU - Jochim,Angela, AU - Meindl,Tobias, AU - Mantel,Tobias, AU - Zwirner,Silke, AU - Zech,Michael, AU - Castrop,Florian, AU - Haslinger,Bernhard, Y1 - 2019/05/02/ PY - 2019/04/02/received PY - 2019/04/26/accepted PY - 2019/04/25/revised PY - 2019/5/3/pubmed PY - 2019/5/3/medline PY - 2019/5/4/entrez KW - AbobotulinumtoxinA KW - Botulinum toxin A KW - Cervical dystonia KW - Long-term treatment KW - OnabotulinumtoxinA SP - 1879 EP - 1886 JF - Journal of neurology JO - J. Neurol. VL - 266 IS - 8 N2 - INTRODUCTION: Treatment with botulinum toxin A is the evidence-based first-line therapy of cervical dystonia. The aim of this study was to analyze long-term data of the most commonly used products concerning safety and efficacy in a big cohort over decades. METHODS: We retrospectively analyzed the treatment data of all cervical dystonia patients in our outpatient clinic having at least three treatment sessions with current onabotulinumtoxinA or abobotulinumtoxinA. The observation period was up to 17 years for onabotulinumtoxinA and 27 years for abobotulinumtoxinA. We report on safety and efficacy, comparing parameters such as dose, treatment intervals, side effects, occurrence and reasons of primary or secondary non-response. RESULTS: We analyzed a total of 2592 and 6660 treatment sessions in 135 patients with onabotulinumtoxinA, 209 with abobotulinumtoxinA and 10 having received both preparations. We found a moderate increase of dosage in the first years which was succeeded by a stable mean dose (138 and 663 mouse units, respectively) and stable injection intervals from the beginning. The most frequent side effects were mild dysphagia (2/6%), muscle weakness (2/6%) and pain (2/2%). Reasons for therapy discontinuation were change to a nearby doctor, age, other diseases, spontaneous improvement, side effects or possible treatment failure. Of all patients, only two tested positive for neutralizing antibodies against botulinum toxin A. CONCLUSION: We show that treatment of cervical dystonia with the two most frequently used botulinum toxin A preparations is a safe and effective therapy even over a long treatment duration of up to 27 years. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/31049731/Treatment_of_cervical_dystonia_with_abo-_and_onabotulinumtoxinA:_long-term_safety_and_efficacy_in_daily_clinical_practice L2 - https://dx.doi.org/10.1007/s00415-019-09349-2 DB - PRIME DP - Unbound Medicine ER -