Neutralizing botulinum toxin type a antibodies: clinical observations in patients with cervical dystonia.
Neutralization of antibodies poses a problem for a substantial number of cervical dystonia (CD) patients treated with botulinum toxin type A (BoNT/A). Presence of these antibodies may lead to a secondary nonresponse to BoNT/A treatment. In this study, we compared 6 antibody-positive (Ab+) with 12 antibody- negative (Ab-) CD patients treated with BoNT/A (Dysport) and matched for du- ration of treatment, number of BoNT/A injections, and severity of clinical symptoms. The two groups differed in cumulative BoNT/A dose (Ab+, 5984 mouse units [MU ], SD = 3151 MU; Ab-, 3143 MU, SD =1294 MU; P <.05), in addition, ab+ patients were significantly younger (ab+ mean age = 41.3 y, sd =5.9 y; ab - mean age = 56.8 y, sd = 15.3 y; p <.05), in or- der to avoid formation of neutralizing antibodies, doses of bont/a should be kept as low as possible, the risk of antibody formation seems to be higher in younger patients.
Rollnik
J D
JD
Department of Neurology and Clinical Neurophysiology, Medical School of Hannover, Hannover, Germany. rollnik.jens@mh-hannover.de
Wohlfarth
K
K
Dengler
R
R
Bigalke
H
H
D000328:Adult; D000367:Age Factors; D000906:Antibodies / Q000009:adverse effects / Q000097:blood*; D019274:Botulinum Toxins, Type A / Q000037:antagonists & inhibitors / Q000276:immunology* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004306:Dose-Response Relationship, Immunologic; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012698:Serologic Tests; D014103:Torticollis / Q000097:blood / Q000188:drug therapy* / Q000276:immunology
D000906:Antibodies; D019274:Botulinum Toxins, Type A