Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA
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...
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doaj-011a9a47583b416fa0cd31412d77c5de2020-11-25T03:52:17ZengMDPI AGToxins2072-66512020-10-011267767710.3390/toxins12110677Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinAHarald Hefter0Sara Samadzadeh1Marek Moll2Department of Neurology, University of Düsseldorf, Moorenstraße 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, University of Düsseldorf, Moorenstraße 5, D-40225 Düsseldorf, GermanyDepartment of Neurology, University of Düsseldorf, Moorenstraße 5, D-40225 Düsseldorf, GermanyBackground: 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 (<i>p</i> < 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.https://www.mdpi.com/2072-6651/12/11/677secondary non-responseantibody inductionbotulinum toxin type Abotulinum toxin type Bcervical dystonia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Harald Hefter Sara Samadzadeh Marek Moll |
spellingShingle |
Harald Hefter Sara Samadzadeh Marek Moll Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA Toxins secondary non-response antibody induction botulinum toxin type A botulinum toxin type B cervical dystonia |
author_facet |
Harald Hefter Sara Samadzadeh Marek Moll |
author_sort |
Harald Hefter |
title |
Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA |
title_short |
Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA |
title_full |
Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA |
title_fullStr |
Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA |
title_full_unstemmed |
Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA |
title_sort |
transient improvement after switch to low doses of rimabotulinumtoxinb in patients resistant to abobotulinumtoxina |
publisher |
MDPI AG |
series |
Toxins |
issn |
2072-6651 |
publishDate |
2020-10-01 |
description |
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 (<i>p</i> < 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. |
topic |
secondary non-response antibody induction botulinum toxin type A botulinum toxin type B cervical dystonia |
url |
https://www.mdpi.com/2072-6651/12/11/677 |
work_keys_str_mv |
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