Botulinum toxin type B for treatment of axillar hyperhidrosis

Dressler, Dirk; Saberi, Fereshte Adib

doi:10.1007/s00415-002-0929-4

Cited by 93 publications

(59 citation statements)

References 11 publications

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“…This is in accordance with previous clinical studies (15,16). Moreover, the study confirms previous observations of NeuroBloc as an autonomic and sudomotor neurone-specific agent with comparatively poor effect on muscles (12,15,17). when comparing the dose conversion ratios between type A and B toxins for anhidrotic effect (ratio 1:1-2) and relaxing effect on muscles (ratio 1:50-100), an opportunity to treat hyperhidrosis in special groups becomes apparent.…”

Section: Discussionsupporting

confidence: 79%

Effect of Botulinum Toxin Concentration on Reduction in Sweating: A Randomized, Double-blind Study

Rystedt¹,

Karlqvist²,

Bertilsson³

et al. 2013

Acta Derm Venerol

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Dose-response studies of botulinum toxin for reduction of sweating are sparse in the literature. The aim of this study was to determine the most appropriate concentrations of Botox ® , Dysport ® , Xeomin ® and NeuroBloc ® , respectively, in order to achieve the greatest reduction in sweating, thus reducing the costs and increasing the safety of treatment. Four concentrations of each product were investigated. Intradermal injections of all products and concentrations were applied to the backs of 20 consenting subjects, in a randomized, double-blind manner. Areas of anhidrotic and hypohidrotic skin were measured with an iodine-starch test after 4, 8 and 12 weeks, respectively. Optimal concentrations were found to be 25 U/ml for Botox and Xeomin, approximately 100 U/ml for Dysport, and 50 U/ml for NeuroBloc. When comparing the mean anhidrotic area per unit for 100 U/ml of each product, the calculated dose conversion ratios were 1:1.6:1.2:1.3 (Botox:Dysport:Xeomin:NeuroBloc). If, instead, the optimal concentration for each product was compared, the dose conversion ratios were 1:4.8:1.3:2.2. Thus, it is crucial to consider botulinum toxin concentration in a treatment regimen.

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Section: Discussionsupporting

confidence: 79%

Effect of Botulinum Toxin Concentration on Reduction in Sweating: A Randomized, Double-blind Study

Rystedt¹,

Karlqvist²,

Bertilsson³

et al. 2013

Acta Derm Venerol

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“…In the first arm 36 patients received MyoBloc ™ 5000 MU; in the second, 37 patients received MyoBloc ™ 10000 MU and in the third arm, 36 patients were treated with placebo. After BT-B became commercially available, the first experience indicated a special adverse effect profile (Dressler and Benecke, 2002) stimulating the first independent adverse effect study on BT-B (Dressler et al, 2003). In this study 24 patients with cervical dystonia were included.…”

Section: Adverse Effect Profilementioning

confidence: 99%

“…The first clinical experience was published in 1999 (Brashear et al, 1999;Brin et al, 1999). As shown in table I BT-B has been used since then for treatment of various conditions, including cervical dystonia (Brashear et al, 1999), hyperhidrosis (Dressler et al, 2002), spasticity syndromes (Oechsner, 2002;, cerebral palsy (Schwerin et al, 2004), hemifacial spasm (Tousi et al, 2004), bladder dysfunction (Dykstra et al, 2003), spasmodic dysphonia (Sataloff et al, 2002), sialorrhoea (Racette et al, 2003), anal fissures (Jost, 2001), piriformis syndrome (Lang, 2004), various pain conditions (Fadeyi and Adams, 2002) and cosmetic applications (Kim et al, 2003).…”

Section: Introductionmentioning

confidence: 98%

“…For use at the neuromuscular junction a conversion ratio between BOTOX ® and MyoBloc ™ of 1 : 40 has been suggested (Dressler et al, 2002) and this ratio was selected in the double-blind, randomized study designed to compare the two serotypes (Comella et al, 2005). For use at autonomic synapses the conversion ratio might be 1:20 (Dressler et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

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Clinical use of non-a botulinum toxins: botulinum toxin type B

Dressler

Eleopra²

2006

neurotox res

Self Cite

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Botulinum neurotoxin type B (BT, BT-B) has been used as NeuroBloc/MyoBloc since 1999 for treatment of cervical dystonia, hyperhidrosis, spastic conditions, cerebral palsy, hemifacial spasm, bladder dysfunction, spasmodic dysphonia, sialorrhoea, anal fissures, piriformis syndrome, various pain conditions and cosmetic applications. Generally, its therapeutic effects are comparable to BT type A (BT-A). The adverse effect profiles of BT-B and BT-A, however, differ considerably. BT-B has been found to produce more regional as well as systemic anticholinergic adverse effects, such as dryness of mouth, accommodation difficulties, conjunctival irritation, reduced sweating, dysphagia, heartburn, constipation, bladder voiding difficulties and dryness of nasal mucosa. In BT-B the relationship between autonomic and motor effects known from BT-A is substantially shifted towards autonomic effects. BT-B, therefore, should be used carefully in patients with autonomic disorders and in patients with concomitant anticholinergic therapy. If NeuroBloc/MyoBloc is used to treat cervical dystonia patients with antibody-induced failure of BT-A therapy, 86% of those will develop complete secondary therapy failure after five applications. If NeuroBloc/MyoBloc used to treat cervical dystonia patients without prior exposure to BT, 44% of those will develop complete secondary therapy failure after nine applications. NeuroBloc/MyoBloc, therefore, is associated with substantial antigenicity problems originating from a particular low specific biological potency. Systemic anticholinergic adverse effects and high antigenicity limits the clinical use of NeuroBloc/MyoBloc considerably.

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“…Studien mit Xeomin® liegen aktuell jedoch nur für die axilläre Hyperhidrose vor. Bei der axil lären Hyperhidrose scheint ein Botox® Neurobloc®Konversionsfaktor von 1:20 angemessen zu sein, während er bei der Behandlung des FreySyndroms und bei neuromuskulärer Behandlungsindikation 1:40 oder weniger betragen kann [5,9]. …”

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Botulinumtoxin bei fokaler Hyperhidrose

2012

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Eight years after its approval, intralesional injections of botulinum toxin type A have become established as an easily performed, highly effective and almost complication-free therapeutic option in primary axillary hyperhidrosis. Sweat production is decreased to about a sixth of previous amounts, and the effect persists for 7 months on average. Restoration of the often significantly impaired quality of life has been convincingly documented in large studies. The effect of botulinum toxin is based on the inhibition of the release of acetylcholine into the synaptic cleft. In addition to this approved use, botulinum toxin is also successfully employed in other forms of focal hyperhidrosis, particularly in gustatory sweating. However, its use in palmoplantar hyperhidrosis, the second most common form of primary hyperhidrosis, is limited because of the pain from numerous injections, need for increased doses of the expensive toxin and the relatively short effective period of about 4 months. Botulinum toxin type B appears to be comparably effective as type A products but is more often associated with systemic adverse events.

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Botulinum toxin type B for treatment of axillar hyperhidrosis

Cited by 93 publications

References 11 publications

Effect of Botulinum Toxin Concentration on Reduction in Sweating: A Randomized, Double-blind Study

Effect of Botulinum Toxin Concentration on Reduction in Sweating: A Randomized, Double-blind Study

Clinical use of non-a botulinum toxins: botulinum toxin type B

Botulinumtoxin bei fokaler Hyperhidrose

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