Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus
Background:. Botulinum neurotoxin A (BoNT-A) injection is the most widely performed aesthetic procedure and a first-line therapeutic option for various medical conditions. The potential for BoNT-A immunoresistance and secondary nonresponse related to neutralizing antibody (NAb) formation warrants at...
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-06-01
|
| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004407 |
| _version_ | 1818249700519706624 |
|---|---|
| author | Wilson W. S. Ho, MBChB, FRCSEd Philipp Albrecht, MD Pacifico E. Calderon, MD, MBEth Niamh Corduff, MBBS, FRACS David Loh, MBBS Michael U. Martin, PhD Je-Young Park, MD Lis S. Suseno, MD Fang-Wen Tseng, MD Vasanop Vachiramon, MD Rungsima Wanitphakdeedecha, MD, MA, MSc Chong-Hyun Won, MD, PhD Jonathan N. T. Yu, MD Mary Dingley, MBBS, FACCSM, FCPCA |
| author_facet | Wilson W. S. Ho, MBChB, FRCSEd Philipp Albrecht, MD Pacifico E. Calderon, MD, MBEth Niamh Corduff, MBBS, FRACS David Loh, MBBS Michael U. Martin, PhD Je-Young Park, MD Lis S. Suseno, MD Fang-Wen Tseng, MD Vasanop Vachiramon, MD Rungsima Wanitphakdeedecha, MD, MA, MSc Chong-Hyun Won, MD, PhD Jonathan N. T. Yu, MD Mary Dingley, MBBS, FACCSM, FCPCA |
| author_sort | Wilson W. S. Ho, MBChB, FRCSEd |
| collection | DOAJ |
| description | Background:. Botulinum neurotoxin A (BoNT-A) injection is the most widely performed aesthetic procedure and a first-line therapeutic option for various medical conditions. The potential for BoNT-A immunoresistance and secondary nonresponse related to neutralizing antibody (NAb) formation warrants attention as the range of BoNT-A aesthetic applications continues to expand.
Methods:. An international multidisciplinary panel reviewed published evidence on BoNT-A immunoresistance in aesthetic and therapeutic applications and discussed best practices integrating clinical, ethical, and aesthetic considerations. Consensus statements relating to awareness, assessment, and management of the risk of NAb-related secondary nonresponse in aesthetic practice were developed.
Results:. There was a consensus that, as doses used in aesthetic practice become like those in therapeutics, rates of NAb formation may be expected to increase. However, the true extent of NAb formation in aesthetics is likely underestimated due to limitations of published evidence and variability in treatment patterns of aesthetic patients. Since BoNT-A therapy is often lifelong, practitioners need to recognize immunogenicity as a potential complication that might affect future therapeutic use and strive to minimize modifiable risk factors. The selection and use of a BoNT-A product with the least immunogenic potential from the beginning may thus be advantageous, especially when treatment with high doses is planned.
Conclusions:. In view of current trends in BoNT-A aesthetic use, it is essential for practitioners to conduct thorough clinical assessments, inform patients of treatment risks, and develop BoNT-A treatment plans to minimize immunogenicity. This can help preserve the option of continued or future BoNT-A treatment with satisfactory outcomes. |
| first_indexed | 2024-12-12T15:40:40Z |
| format | Article |
| id | doaj.art-d3d0a0c0a8e34491a526fb886264d38c |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-12T15:40:40Z |
| publishDate | 2022-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-d3d0a0c0a8e34491a526fb886264d38c2022-12-22T00:19:55ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-06-01106e440710.1097/GOX.0000000000004407202206000-00046Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and ConsensusWilson W. S. Ho, MBChB, FRCSEd0Philipp Albrecht, MD1Pacifico E. Calderon, MD, MBEth2Niamh Corduff, MBBS, FRACS3David Loh, MBBS4Michael U. Martin, PhD5Je-Young Park, MD6Lis S. Suseno, MD7Fang-Wen Tseng, MD8Vasanop Vachiramon, MD9Rungsima Wanitphakdeedecha, MD, MA, MSc10Chong-Hyun Won, MD, PhD11Jonathan N. T. Yu, MD12Mary Dingley, MBBS, FACCSM, FCPCA13From the * The Specialists: Lasers, Aesthetics and Plastic Surgery, Central, Hong Kong† Department of Neurology, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany‡ Department of Professionalism, Medical Ethics and Humanities, College of Medicine, St. Luke’s Medical Center, Quezon City, the Philippines§ Cosmetic Refinement Clinic Geelong, Geelong, Victoria, Australia¶ David Loh Surgery, Singapore∥ Retired, Springe, Germany** Apkoo-Jung Oracle Dermatology Clinic, Seoul, Korea†† Division of Cosmetic Dermatology, Department of Dermatology and Venereology, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia‡‡ Taoyuan Milano Aesthetic Clinic, Taoyuan, Taiwan§§ Division of Dermatology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand¶¶ Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand∥∥ Department of Dermatology, Ulsan University School of Medicine, Seoul, Korea*** JY Dermatology and Aesthetic Center, Metro Manila, Philippines††† The Cosmetic Medicine Centre, Toowong, Queensland, Australia.Background:. Botulinum neurotoxin A (BoNT-A) injection is the most widely performed aesthetic procedure and a first-line therapeutic option for various medical conditions. The potential for BoNT-A immunoresistance and secondary nonresponse related to neutralizing antibody (NAb) formation warrants attention as the range of BoNT-A aesthetic applications continues to expand. Methods:. An international multidisciplinary panel reviewed published evidence on BoNT-A immunoresistance in aesthetic and therapeutic applications and discussed best practices integrating clinical, ethical, and aesthetic considerations. Consensus statements relating to awareness, assessment, and management of the risk of NAb-related secondary nonresponse in aesthetic practice were developed. Results:. There was a consensus that, as doses used in aesthetic practice become like those in therapeutics, rates of NAb formation may be expected to increase. However, the true extent of NAb formation in aesthetics is likely underestimated due to limitations of published evidence and variability in treatment patterns of aesthetic patients. Since BoNT-A therapy is often lifelong, practitioners need to recognize immunogenicity as a potential complication that might affect future therapeutic use and strive to minimize modifiable risk factors. The selection and use of a BoNT-A product with the least immunogenic potential from the beginning may thus be advantageous, especially when treatment with high doses is planned. Conclusions:. In view of current trends in BoNT-A aesthetic use, it is essential for practitioners to conduct thorough clinical assessments, inform patients of treatment risks, and develop BoNT-A treatment plans to minimize immunogenicity. This can help preserve the option of continued or future BoNT-A treatment with satisfactory outcomes.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004407 |
| spellingShingle | Wilson W. S. Ho, MBChB, FRCSEd Philipp Albrecht, MD Pacifico E. Calderon, MD, MBEth Niamh Corduff, MBBS, FRACS David Loh, MBBS Michael U. Martin, PhD Je-Young Park, MD Lis S. Suseno, MD Fang-Wen Tseng, MD Vasanop Vachiramon, MD Rungsima Wanitphakdeedecha, MD, MA, MSc Chong-Hyun Won, MD, PhD Jonathan N. T. Yu, MD Mary Dingley, MBBS, FACCSM, FCPCA Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus Plastic and Reconstructive Surgery, Global Open |
| title | Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus |
| title_full | Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus |
| title_fullStr | Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus |
| title_full_unstemmed | Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus |
| title_short | Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus |
| title_sort | emerging trends in botulinum neurotoxin a resistance an international multidisciplinary review and consensus |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004407 |
| work_keys_str_mv | AT wilsonwshombchbfrcsed emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT philippalbrechtmd emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT pacificoecalderonmdmbeth emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT niamhcorduffmbbsfracs emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT davidlohmbbs emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT michaelumartinphd emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT jeyoungparkmd emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT lisssusenomd emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT fangwentsengmd emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT vasanopvachiramonmd emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT rungsimawanitphakdeedechamdmamsc emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT chonghyunwonmdphd emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT jonathanntyumd emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus AT marydingleymbbsfaccsmfcpca emergingtrendsinbotulinumneurotoxinaresistanceaninternationalmultidisciplinaryreviewandconsensus |