scholarly journals Transient Improvement after Switch to Low Doses of RimabotulinumtoxinB in Patients Resistant to AbobotulinumtoxinA

Toxins ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 677
Author(s):  
Harald Hefter ◽  
Sara Samadzadeh ◽  
Marek Moll
Keyword(s):  
Botulinum Toxin ◽  
Treatment Failure ◽  
Clinical Effect ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Secondary Treatment ◽  
Low Doses ◽  
Global Assessment Scale ◽  
Botulinum Toxin Type B ◽  
Transient Improvement

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. 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. 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 (p < 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. 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.

scholarly journals Botulinum toxin type A versus botulinum toxin type B for cervical dystonia

2016 ◽  
Author(s):  
Gonçalo S Duarte ◽  
Mafalda Castelão ◽  
Filipe B Rodrigues ◽  
Raquel E Marques ◽  
Joaquim Ferreira ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Cervical Dystonia ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Type B ◽  
Botulinum Toxin Type B

Botulinum Toxin Injections for Facial Rhytides

2011 ◽  
Author(s):  
Jill A. Foster ◽  
Matthew P. Ohr
Keyword(s):  
Nervous System ◽  
Botulinum Toxin ◽  
Botulinum Toxin Type A ◽  
Type A ◽  
Botulinum Toxin Type ◽  
Botulinum Toxin Type B ◽  
Release Of Acetylcholine ◽  
To Come ◽  
Different Strains ◽  
The U.S

Once feared for its deadly properties, Botulinum toxin is now revered for its effectiveness as a treatment in minimally invasive facial rejuvenation. The injection of Botulinum toxin is the most frequently performed nonsurgical cosmetic procedure, with at least 4.8 million procedures in 2009. First approved by the U.S. Food and Drug Administration (FDA) in 1979 for the treatment of strabismus, Botulinum toxin was shown to be both safe and effective for use to decrease muscle function. Botulinum toxin’s cosmetic applications were first recognized when it was noted that facial rhytides improved in the areas of treatment with the toxin when it was used for noncosmetic applications in the late 1980s and early 1990s. FDA approval for cosmetic treatment of the glabellar furrows was announced in 2002, and off-label aesthetic indications have continued to evolve. Botulinum toxin is produced by the gram-positive, anaerobic Clostridium botulinum. The neurotoxin acts on the peripheral nervous system, where it inhibits release of acetylcholine from the presynaptic terminal at the neuromuscular junction. There are seven distinct antigenic Botulinum toxins (BTX-A, B, C, D, E, F, and G) produced by different strains of C. botulinum. The human nervous system is susceptible to only five of these serotypes (BTX-A, B, E, F, G), and types A and B are currently available for human injection. In the United States, there are four commercially available Botulinum toxin preparations: three types of Botulinum toxin type A, OnabotulinumtoxinA or Botox Cosmetic® (Allergan, Inc., Irvine, CA), IncobotulinumtoxinA or Xeomin (Merz, Frankfort Germany), and abobotulinumtoxinA or Dysport (Medicis, Scottsdale, AZ). There is one preparation of Botulinum toxin type B, RimabotulinumtoxinB or Myobloc® (Elan Pharmaceuticals, San Diego, CA). Other Botulinum toxin type A products are anticipated to come to the U.S. market in the next decade as well. Different formulations of Botulinum toxin type A are biochemically unique and are not necessarily equivalent in dosing. The Botox unit is three times as potent as the Dysport unit, but this conversion ratio does not take into consideration safety or antigenic potential. Practically speaking, a range of 2.5 to 3 to one has been recommended to make Dysport dosing approximate the effects of Botox.

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