Botulinum toxin type A therapy for hemifacial spasm

Costa, João; Ferreira, JJ; Coelho, Miguel; Borges, Ana A; Espírito-Santo, C; Moore, Peter; Sampaio, Cristina

doi:10.1002/14651858.cd004899

Cited by 23 publications

(27 citation statements)

References 29 publications

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“…Although botulinum neurotoxin injections are currently the mainstay of therapy, other therapies are on the horizon. 17,38,46,63,64 …”

Section: Discussionmentioning

confidence: 99%

“…Although neurosurgical treatment is available, the potential complications and relatively high recurrence rate have made botulinum toxin A the preferred symptomatic treatment for HFS. [34][35][36][37][38][39] As HFS rarely remits spontaneously, 40 most patients need to continue BoNT-A treatment for many years, if not for the rest of their lives. The long-term efficacy and safety of BoNT-A are, therefore, increasingly important questions.…”

Section: Introductionmentioning

confidence: 99%

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Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes

Cillino

Raimondi

Guépratte

et al. 2009

Eye

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Purpose To investigate the long-term effectiveness and safety of botulinum neurotoxin A (BoNT-A) treatment in patients with blepharospasm (BEB), hemifacial spasm (HFS), and entropion (EN) and to use for the first time two modified indexes, 'botulin toxin escalation index-U' (BEI-U) and 'botulin toxin escalation index percentage' (BEI-%), in the dose-escalation evaluation. Methods All patients in this multicentre study were followed for at least 10 years and main outcomes were clinical efficacy, duration of relief, BEI-U and BEI-%, and frequency of adverse events. Results BEB, HFS, and EN patients received a mean BoNT-A dose with a significant intergroup difference (Po0.0005, respectively). The mean ( ± SD) effect duration was statistically different (P ¼ 0.009) among three patient groups. Regarding the BoNT-A escalation indexes, the mean ( ± SD) values of BEI-U and BEI-% were statistically different (P ¼ 0.035 and 0.047, respectively) among the three groups. In BEB patients, the BEI-% was significantly increased in younger compared with older patients (P ¼ 0.008). The most frequent adverse events were upper lid ptosis, diplopia, ecchymosis, and localized bruising. Conclusions This long-term multicentre study supports a high efficacy and good safety profile of BoNT-A for treatment of BEB, HFS, and EN. The BEI indexes indicate a significantly greater BoNT-A-dose escalation for BEB patients compared with HFS or EN patients and a significantly greater BEI-% in younger vs older BEB patients. These results confirm a greater efficacy in the elderly and provide a framework for long-term studies with a more flexible and reliable evaluation of drug-dose escalation.

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“…Although botulinum neurotoxin injections are currently the mainstay of therapy, other therapies are on the horizon. 17,38,46,63,64 …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes

Cillino

Raimondi

Guépratte

et al. 2009

Eye

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“…Our data clearly indicate that BTA treatment is a relatively lowcost treatment when injections are performed in the small muscles (face, upper limb). Several metaanalyses have shown that BTA treatment is effective in facial dystonia, facial hemispasm [5][6][7]13], and cervical dystonia [6,19]. In the latter, treatment cost is higher but BTA offers a real functional gain in these severely distressed patients, with significant improvement in clinical symptoms, associated pain, and quality of life.…”

Section: Discussionmentioning

confidence: 99%

Botulinum toxin treatment in neurological practice: how much does it really cost? A prospective cost-effectiveness study

et al. 2011

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Botulinum toxin (BTA) is a safe and effective therapeutic tool for many neurological conditions but few studies have investigated its real cost in neurological practice. We evaluated the daily cost of botulinum toxin type A (BTA) treatment through a cost effectiveness analysis alongside a prospective study of BTA injections at a French University Hospital over a 2-year follow-up period. The data of 3,108 BTA injections performed in 870 adult patients presenting with dystonia, facial hemispasm, or spasticity were entered in the database. Patients were questioned at each visit about the subjective effectiveness of the previous injection. The daily cost of BTA treatment was calculated as the ratio of each session's cost (including all additional costs) to the duration of subjective efficacy. The subjective rating of efficacy duration was 17.3 ± 7.7 weeks for facial hemispasm, 15.4 ± 7.7 for blepharospasm, 14.3 ± 6.7 for cervical dystonia, 14.5 ± 7.8 and 14.1 ± 7.4 weeks for upper and lower limb spasticity, respectively. The daily cost of BTA injections was 0.57 ± 0.20 for facial hemispasm, 0.95 ± 0.30 for blepharospasm, 2.85 ± 0.86 for cervical dystonia, 3.38 ± 1.49 and 3.62 ± 1.81 for upper and lower limb spasticity, respectively. When associated costs were considered, the daily cost of BTA injections was clearly increased (45-93%) in limb spasticity or rigidity but remained only modestly increased (15-37%) in other indications. These results obtained in a large cohort of patients show that BTA treatment has a low daily cost for a long-lasting effect, with a daily cost/benefit ratio that greatly depends on the indications.

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“…Bei Spasmus hemifacialis werden mit Botulinumtoxin A Responderraten zwischen 76-100% erreicht (19). Praktisch alle der zahlreichen Studien wurden ohne EMG-Kontrolle durchgeführt.…”

Section: Blepharospasmus Und Spasmus Hemifacialisunclassified

EMG-Steuerung bei Botulinumtoxin-Therapie: sinnvoll oder überflüssig?

Ceballos-Baumann¹

2005

psychoneuro

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Botulinum toxin type A therapy for hemifacial spasm

Cited by 23 publications

References 29 publications

Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes

Long-term efficacy of botulinum toxin A for treatment of blepharospasm, hemifacial spasm, and spastic entropion: a multicentre study using two drug-dose escalation indexes

Botulinum toxin treatment in neurological practice: how much does it really cost? A prospective cost-effectiveness study

EMG-Steuerung bei Botulinumtoxin-Therapie: sinnvoll oder überflüssig?

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