Abstract |
Short-term studies of cervical dystonia (CD) have demonstrated botulinum toxin type B (Bot B) to be safe and efficacious at doses of 5,000 to 10,000 units, but few long-term studies have been published and the safety and efficacy of higher doses has not been established. Additionally, there are few studies describing the development of resistance to Bot B in those with and without prior resistance to botulinum toxin type A (Bot A). We reviewed our experience with 24 patients treated with Bot B for up to 64 months. Patients were treated with Bot B for 26.2 +/- 20.4 months (range, 3-64 months) with a mean treatment dose of 14,828 +/- 6,824 units (range, 2,500-28,000 units). At last follow-up, 12 patients demonstrated ongoing benefit, 8 patients had become secondarily resistant, and 4 patients were primary nonresponders possibly due to the severity and nature of their CD. Nine of the 12 continued responders and 7 of the 8 secondary nonresponders to Bot B had prior probable or definite clinical resistance to Bot A. No severe adverse events related to Bot B were seen. Treatment of patients with severe CD who continue to show a beneficial response to Bot B injections commonly requires doses of 15,000 units and rarely greater than 20,000 units. Patients may continue to respond for up to 64 months. Prior Bot A resistance may be a risk factor for the development of resistance to Bot B; nevertheless, Bot B can be a useful long-term alternative in some Bot A-resistant CD patients.
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Authors | Brian Berman, Lauren Seeberger, Rajeev Kumar |
Journal | Movement disorders : official journal of the Movement Disorder Society
(Mov Disord)
Vol. 20
Issue 2
Pg. 233-7
(Feb 2005)
ISSN: 0885-3185 [Print] United States |
PMID | 15455449
(Publication Type: Clinical Trial, Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright 2004 Movement Disorder Society. |
Chemical References |
- Anti-Dyskinesia Agents
- rimabotulinumtoxinB
- Botulinum Toxins
- Botulinum Toxins, Type A
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Anti-Dyskinesia Agents
(therapeutic use)
- Botulinum Toxins
(therapeutic use)
- Botulinum Toxins, Type A
(adverse effects)
- Disability Evaluation
- Dose-Response Relationship, Drug
- Drug Resistance
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Retrospective Studies
- Risk Factors
- Time
- Torticollis
(drug therapy)
- Treatment Outcome
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