Transient Improvement After Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA

Overview

Journal Toxins (Basel)

Publisher MDPI

Specialty Toxicology

Date 2020 Oct 30

PMID 33121133

Citations 3

Authors

Harald Hefter

Sara Samadzadeh

Marek Moll

Affiliations

Soon will be listed here.

Abstract

Background: Botulinum toxin type B (BoNT/B) has been recommended as an alternative for patients who have become resistant to botulinum toxin type A (BoNT/A). This study aimed to compare the clinical effect, within a patient, of four injections with low doses of rimabotulinumtoxinB with the effect of the preceding abobotulinumtoxinA (aboBoNT/A) injections.

Methods: In 17 patients with cervical dystonia (CD) who had become resistant to aboBoNT/A, the clinical effect of the first four rimabotulinumtoxinB (rimaBoNT/B) injections was compared to the effect of the first four aboBoNT/A injections using a global assessment scale and the TSUI score.

Results: After the first two BoNT/B injections, all 17 patients responded well and to a similar extent as to the first two BoNT/A injections, but with more side effects such as dry mouth and constipation. After the next BoNT/B injection, the improvement started to decline. The response to the fourth BoNT/B injection was significant ( < 0.048) lower than the fourth BoNT/A injection. Only three patients developed a complete secondary treatment failure (CSTF) and five patients a partial secondary treatment failure (PSTF) after four BoNT/B injections. In nine patients, the usual response persisted.

Conclusion: With the use of low rimaBoNT/B doses, the induction of CSTF and PSTF to BoNT/B could not be avoided but was delayed in comparison to the use of higher doses. In contrast to aboBoNT/A injections, PSTF and CSTF occurred much earlier, although low doses of rimaBoNT/B had been applied.

Citing Articles

Significant Long-Lasting Improvement after Switch to Incobotulinum Toxin in Cervical Dystonia Patients with Secondary Treatment Failure.

Hefter H, Urer B, Brauns R, Rosenthal D, Meuth S, Lee J Toxins (Basel). 2022; 14(1).

PMID: 35051021 PMC: 8779547. DOI: 10.3390/toxins14010044.

Immunogenicity of Botulinum Toxin Formulations: Potential Therapeutic Implications.

Carr W, Jain N, Sublett J Adv Ther. 2021; 38(10):5046-5064.

PMID: 34515975 PMC: 8478757. DOI: 10.1007/s12325-021-01882-9.

The Extreme Ends of the Treatment Response Spectrum to Botulinum Toxin in Cervical Dystonia.

Samadzadeh S, Brauns R, Hefter H Toxins (Basel). 2021; 13(1).

PMID: 33396548 PMC: 7824374. DOI: 10.3390/toxins13010022.

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