Abstract
We sought to explore the therapeutic effect of botulinum toxin (BT) therapy by analysing the time between the BT application and the onset of its decrease (treatment duration, TD), the inter-injection interval (II), and the excess time (ET, ET = II-TD). For this we studied 59 patients (37 females, 22 males, age 52.6 ± 10.9 years) with cervical dystonia (CD, Tsui score 9.0 ± 4.1) and BT therapy with Botox® and/or Xeomin® sequentially. Altogether 1,289 treatment cycles were evaluated. On average 21.8 ± 14.0 (4–66) treatment cycles were recorded for each patient. TD was 11.8 ± 2.7 weeks (7.8 ± 1.4 to 21.0 ± 3.9 weeks), II 15.4 ± 3.4 weeks (11.3 ± 1.3 to 27.8 ± 11.6 weeks) and ET 3.5 ± 2.4 weeks (23 % of II). TD and II were stable throughout the treatment course. In 36 % of the patients we found TD ≤10 weeks, in 83 % TD ≤12 weeks. In 17 % of the patients we saw treatment delays due to appointment difficulties, due to the patient’s attempts to explore TD or his actual CD severity, from fear of adverse effects or due to psychiatric comorbidity. 19 % of the patients showed prolonged treatment effects probably due to CD fluctuations. 0.38 % of the injection series produced singular unexplained therapy failure (SUTF). Antibody-induced therapy failure did not occur. TD and II are stable on long-term monitoring. SUTF, treatment delays, and CD fluctuations can occur. 23 % of the time patients are treated suboptimally. Our data suggest to reduce II. If II is to be reduced to ≤12 weeks, use of low antigenicity BT drugs might be useful.
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Dressler D (2004) Clinical presentation and management of antibody-induced failure of botulinum toxin therapy. Mov Disord Suppl 8:S92–S100
Dressler D (2009) Routine use of Xeomin® in patients pre-treated with Botox®. Eur J Neurol 16(Suppl 2):2–5
Dressler D (2012) Five-year experience with incobotulinumtoxinA (Xeomin(®)): the first botulinum toxin drug free of complexing proteins. Eur J Neurol 19:385–389
Dressler D, Benecke R, Moore P, Dressler D, Naumann M (2003) Cervical and axial dystonia. In: Moore P, Naumann M (eds) Handbook of Botulinum Toxin Therapy, 2nd edn. Blackwell Science, Oxford, pp 158–194
Dressler D, Mander X, Fink K (2012) Meassuring the potency labelling of onabotulinumtoxinA (Botox®) and Xeomin® in an LD50 assay. J Neural Transm 119:13–15
Dressler D, Tacik P, Adib Saberi F (2014) Botulinum toxin therapy of cervical dystonia: comparing Botox® and Xeomin®. J Neural Transm 121:29–31
Probst TE, Heise H, Heise P, Benecke R, Dressler D (2002) Rare immunologic side effects of botulinum toxin therapy: brachial plexus neuropathy and dermatomyositis. Mov Disord 17(suppl 5):S49
Tsui JK, Calne DB (1988) Botulinum toxin in cervical dystonia. Adv Neurol 49:473–478
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Dressler, D., Tacik, P. & Adib Saberi, F. Botulinum toxin therapy of cervical dystonia: duration of therapeutic effects. J Neural Transm 122, 297–300 (2015). https://doi.org/10.1007/s00702-014-1253-8
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DOI: https://doi.org/10.1007/s00702-014-1253-8