Document Detail

Clinical failure of botulinum toxin A in movement disorders.
MedLine Citation:
PMID:  21880538     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Botulinum toxin (BTX) injections have been used extensively in medicine; however, little is known about the factors predicting the loss of effectiveness of botulin toxin.
METHODS: Using a clinical database, we identified 401 subjects who had been treated for movement disorders from 1998 through 2010 with onabotulinumtoxin A (BTX A) or who switched from BTX A to rimabotulinumtoxin B (BTX B). We compared patients who switched from type A to type B with patients using type A only with regard to number of visits, total number of injections, number of initial and final sites, number of initial units used, and duration of treatments.
RESULTS: We observed that patients who switched from BTX A to B had a significantly higher number of initial injection sites than patients with BTX A only (BTX A to B median = 8.5; BTX A median = 6; p for difference = 0.006), had a higher number of final sites (BTX A to B median = 9 BTX A median = 7; p = 0.01), and were also more likely to have multiple reasons for injection (BTX A to B = 25.0%; botulin toxin A = 5.3%; p = 0.01). We did not find significant differences between groups based on the other variables.
CONCLUSIONS: Our findings suggest that higher number of sites rather than higher number of units or years of treatment are associated with the loss of effectiveness to BTX A. It is possible that the loss of effectiveness to the BTX is more strongly elicited when the injections are widely diffuse.
Rodolfo Savica; Brandon R Grossardt; James H Bower; Bryan T Klassen; Joseph Y Matsumoto
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-08-30
Journal Detail:
Title:  Parkinsonism & related disorders     Volume:  18     ISSN:  1873-5126     ISO Abbreviation:  Parkinsonism Relat. Disord.     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-01-02     Completed Date:  2012-09-12     Revised Date:  2013-11-25    
Medline Journal Info:
Nlm Unique ID:  9513583     Medline TA:  Parkinsonism Relat Disord     Country:  England    
Other Details:
Languages:  eng     Pagination:  73-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
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MeSH Terms
Botulinum Toxins / administration & dosage*
Botulinum Toxins, Type A / administration & dosage*
Injections, Intramuscular
Middle Aged
Movement Disorders / drug therapy*,  immunology,  pathology*
Treatment Failure
Treatment Outcome
Reg. No./Substance:
0/onabotulinumtoxinA; 0Y70779M1F/rimabotulinumtoxinB; EC Toxins; EC Toxins, Type A

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