Die Rolle neutralisierende Antikörper beim sekundären Therapieversagen

Lange, O.; Bigalke, H.; Dengler, R.; Wegner, F.; deGroot, M.; Wohlfahrt, K.

doi:10.1055/s-2007-1032233

Cited by 1 publication

(2 citation statements)

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“…Alternatively, NAb against botulinum neurotoxin A have been suggested to play a role in secondary treatment failure, mostly injected in muscles to decrease spasticity. [10][11][12] One case report described secondary non-response of botulinum neurotoxin B injections in drooling after three successful injections. NAb against neurobotulinum toxin B were identified and additional onabotulinum neurotoxin A injection did not show treatment response either.…”

Section: Discussionmentioning

confidence: 99%

“…8 Neutralizing antibodies (NAb) or parotid gland compensation may play a role in the decrease of the effect after repeated injections, while alternative literature hypothesize gland atrophy and subsequently a permanent reduction in drooling. [9][10][11][12][13] The aim of this study is to evaluate the effect of repeated onabotulinum neurotoxin A injections to reveal the usefulness of repeated injections for the treatment of drooling in neurodisabilities.…”

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confidence: 99%

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Repeated onabotulinum neurotoxin A injections for drooling in children with neurodisability

Bekkers¹,

Leow²,

Hulst

et al. 2021

Develop Med Child Neuro

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NabNeutralizing antibodies VAS Visual analogue scale AIM To evaluate the effect of repeated onabotulinum neurotoxin A injections for the treatment of drooling in children with neurodisabilities.METHOD This was a retrospective cohort study, in which the first, second, and third onabotulinum neurotoxin A injection were compared within children treated between 2000 and 2020. Primary outcomes included drooling quotient, visual analogue scale (VAS), and treatment success defined as ≥50% reduction in drooling quotient and/or VAS 8 weeks after treatment. Each outcome was obtained at baseline and 8 weeks posttreatment.RESULTS Seventy-seven children were included (mean age at first injection: 8y 3mo, SD 3y 7mo, range 3-17y; 44 males, 33 females; 51.9% with cerebral palsy, 45.5% wheelchair-bound).The objective (drooling quotient) and subjective (VAS) effect after the second injection was lower compared to the first injection. The third injection showed less objective and significantly less subjective effect compared to the first injection. An overall success rate of 74.0%, 41.6%, and 45.8% were found for the first, second, and third injection respectively.INTERPRETATION Although onabotulinum neurotoxin A remained effective throughout the entire treatment course, there is less effect of subsequent onabotulinum neurotoxin A injections compared to the first. Although there might be a loss of effect after repeated injections, there is continued improvement for most children.

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Section: Discussionmentioning

confidence: 99%