No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease Severity
The aim of this study was to detect clinical hints regarding the development of secondary treatment failure (STF) in patients with focal dystonia who were exclusively treated with incobotulinumtoxin/A (incoBoNT/A). In total, 33 outpatients (26 with idiopathic cervical dystonia, 4 with Meige syndrome...
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MDPI AG
2023-07-01
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| Series: | Toxins |
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| Online Access: | https://www.mdpi.com/2072-6651/15/7/454 |
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| author | Harald Hefter Raphaela Brauns Beyza Ürer Dietmar Rosenthal Philipp Albrecht Sara Samadzadeh |
| author_facet | Harald Hefter Raphaela Brauns Beyza Ürer Dietmar Rosenthal Philipp Albrecht Sara Samadzadeh |
| author_sort | Harald Hefter |
| collection | DOAJ |
| description | The aim of this study was to detect clinical hints regarding the development of secondary treatment failure (STF) in patients with focal dystonia who were exclusively treated with incobotulinumtoxin/A (incoBoNT/A). In total, 33 outpatients (26 with idiopathic cervical dystonia, 4 with Meige syndrome and 3 with other cranial dystonia) who were treated with repeated injections of incoBoNT/A for a mean period of 6.4 years without interruptions were recruited to draw the course of their disease severity (CoD) from the onset of symptoms to the onset of BoNT therapy (CoDB graph) and from the onset of BoNT therapy to recruitment (CoDA graph). At the time of recruitment, the patients assessed the change in severity as a percentage of the severity at the onset of BoNT therapy. Blood samples were taken to test the presence of neutralizing antibodies (NABs) using the mouse hemidiaphragm assay (MHDA). Patients reported an improvement of about 70% with respect to the mean. None of the patients tested positive for MHDA. Three different types of CoDB and three different types of CoDA graphs could be distinguished. The patients with different CoDB graphs reported different long-term outcomes, but there was no significant difference in long-term outcomes between patients with different CoDA graphs. None of the patients produced a CoDA graph with an initial improvement and a secondary worsening as a hint for the development of STF. A primary non-response was not observed in any of the patients. During long-term treatment with BoNT/A, NABs and/or STF may develop. However, in the present study on patients with incoBoNT/A long-term monotherapy, no hints for the development of NABs or STF could be detected, underlining the low antigenicity of incoBoNT/A. |
| first_indexed | 2024-03-11T00:35:03Z |
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| id | doaj.art-3dafa7e427e4423ea199cf1a4829f06b |
| institution | Directory Open Access Journal |
| issn | 2072-6651 |
| language | English |
| last_indexed | 2024-03-11T00:35:03Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Toxins |
| spelling | doaj.art-3dafa7e427e4423ea199cf1a4829f06b2023-11-18T21:38:25ZengMDPI AGToxins2072-66512023-07-0115745410.3390/toxins15070454No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease SeverityHarald Hefter0Raphaela Brauns1Beyza Ürer2Dietmar Rosenthal3Philipp Albrecht4Sara Samadzadeh5Department of Neurology, Moorenstrasse 5, 40225 Düsseldorf, GermanyDepartment of Neurology, Moorenstrasse 5, 40225 Düsseldorf, GermanyDepartment of Neurology, Moorenstrasse 5, 40225 Düsseldorf, GermanyDepartment of Neurology, Moorenstrasse 5, 40225 Düsseldorf, GermanyDepartment of Neurology, Moorenstrasse 5, 40225 Düsseldorf, GermanyDepartment of Neurology, Moorenstrasse 5, 40225 Düsseldorf, GermanyThe aim of this study was to detect clinical hints regarding the development of secondary treatment failure (STF) in patients with focal dystonia who were exclusively treated with incobotulinumtoxin/A (incoBoNT/A). In total, 33 outpatients (26 with idiopathic cervical dystonia, 4 with Meige syndrome and 3 with other cranial dystonia) who were treated with repeated injections of incoBoNT/A for a mean period of 6.4 years without interruptions were recruited to draw the course of their disease severity (CoD) from the onset of symptoms to the onset of BoNT therapy (CoDB graph) and from the onset of BoNT therapy to recruitment (CoDA graph). At the time of recruitment, the patients assessed the change in severity as a percentage of the severity at the onset of BoNT therapy. Blood samples were taken to test the presence of neutralizing antibodies (NABs) using the mouse hemidiaphragm assay (MHDA). Patients reported an improvement of about 70% with respect to the mean. None of the patients tested positive for MHDA. Three different types of CoDB and three different types of CoDA graphs could be distinguished. The patients with different CoDB graphs reported different long-term outcomes, but there was no significant difference in long-term outcomes between patients with different CoDA graphs. None of the patients produced a CoDA graph with an initial improvement and a secondary worsening as a hint for the development of STF. A primary non-response was not observed in any of the patients. During long-term treatment with BoNT/A, NABs and/or STF may develop. However, in the present study on patients with incoBoNT/A long-term monotherapy, no hints for the development of NABs or STF could be detected, underlining the low antigenicity of incoBoNT/A.https://www.mdpi.com/2072-6651/15/7/454secondary treatment failureprimary treatment failurefocal dystoniacourse of disease (CoD)CoD graphsbotulinum neurotoxin therapy |
| spellingShingle | Harald Hefter Raphaela Brauns Beyza Ürer Dietmar Rosenthal Philipp Albrecht Sara Samadzadeh No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease Severity Toxins secondary treatment failure primary treatment failure focal dystonia course of disease (CoD) CoD graphs botulinum neurotoxin therapy |
| title | No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease Severity |
| title_full | No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease Severity |
| title_fullStr | No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease Severity |
| title_full_unstemmed | No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease Severity |
| title_short | No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease Severity |
| title_sort | no secondary treatment failure during incobotulinumtoxin a long term treatment demonstrated by the drawing of disease severity |
| topic | secondary treatment failure primary treatment failure focal dystonia course of disease (CoD) CoD graphs botulinum neurotoxin therapy |
| url | https://www.mdpi.com/2072-6651/15/7/454 |
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