Long‐term botulinum toxin efficacy, safety, and immunogenicity

Movement Disorders - Tập 20 Số 5 - Trang 592-597 - 2005
Nicte Mejia1, Kevin Dat Vuong1, Joseph Jankovic1
1Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology Baylor College of Medicine Houston Texas USA

Tóm tắt

AbstractTo determine the long‐term efficacy of botulinum toxin (BTX) treatments, we analyzed longitudinal follow‐up data on 45 patients (32 women; mean age, 68.8 years) currently followed in the Baylor College of Medicine Movement Disorders Clinic, who have received BTX treatments continuously for at least 12 years (mean 15.8 ± 1.5 years). Their mean response rating after the last injection, based one a previously described scale 0‐to‐4 scale (0 = no effect; 4 = marked improvement) was 3.7 ± 0.6 and the mean total duration of response was 15.4 ± 3.4 weeks. Although the latency and total duration of the response to treatment have not changed over time, the peak duration of response (P < 0.005) and dose per visit (P < 0.0001) have increased since the initial visit. Furthermore, global rating (P < 0.02) and peak effect (P < 0.05) have improved. In total, 20 adverse events occurred in 16 of 45 (35.6%) patients after their initial visit and 11 adverse events in 10 of 45 (22.2%) patients at their most recent injection visit. Antibody (Ab) testing was carried out in 22 patients due to nonresponsiveness; blocking Abs were confirmed by the mouse protection assay in 4 of 22 (18%) patients. Of the Ab‐negative patients, 16 resumed responsiveness after dose adjustments and2 persisted as nonrespondents. Except for 1 patient, the 4 Ab‐positive and the 2 clinical nonresponders are being treated with BTX‐B. This longest reported follow‐up of BTX injections confirms the long‐term efficacy and safety of this treatment. © 2005 Movement Disorder Society

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