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024 7 _ |a 10.1111/ene.70289
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024 7 _ |a 1468-1331
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037 _ _ |a DZNE-2025-00919
041 _ _ |a English
082 _ _ |a 610
100 1 _ |a Walter, Uwe
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245 _ _ |a Systematic Review and Meta-Analysis of Secondary Treatment Failure and Immunogenicity With Botulinum Neurotoxin A in Multiple Indications.
260 _ _ |a Oxford [u.a.]
|c 2025
|b Wiley-Blackwell
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520 _ _ |a Botulinum neurotoxin A (BoNT-A) is recommended for the treatment of cervical dystonia (CD), spasticity, and blepharospasm. Some patients treated with BoNT-A have been reported to develop neutralizing antibodies (NAbs) against BoNT-A, which may result in reduced efficacy and, in some cases, secondary treatment failure (STF). Our aim was to investigate the incidence of STF and NAb positivity after treatment with one of three commercially-available BoNT-A formulations.A systematic review and meta-analysis of STF and/or NAb positivity after treatment with abobotulinumtoxinA, incobotulinumtoxinA, or onabotulinumtoxinA in patients with CD, spasticity, or blepharospasm was conducted using PubMed, Embase, and Google Scholar.Twenty-nine unique studies reported in 29 publications assessed NAb positivity and were included. The meta-analysis showed that the proportions of patients developing STF were significantly higher after treatment with abobotulinumtoxinA or onabotulinumtoxinA than with incobotulinumtoxinA for CD or spasticity. Depending on the antibody test used, the proportions of patients developing NAbs were also significantly higher after treatment with abobotulinumtoxinA or onabotulinumtoxinA than with incobotulinumtoxinA for CD or spasticity. When data for all indications were pooled, proportions of NAb-positive patients were numerically higher with increasing mean doses of abobotulinumtoxinA or onabotulinumtoxinA. No patients treated exclusively with incobotulinumtoxinA were found to have developed immunogenic STF or persistent NAbs.The risk of developing STF and NAbs appears to vary with indication and BoNT-A formulation. When the efficacy and safety of formulations are comparable, incobotulinumtoxinA may be recommended to avoid developing STF and immunogenicity, particularly for patients requiring higher doses and repeated treatments.
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650 _ 7 |a blepharospasm
|2 Other
650 _ 7 |a botulinum toxin
|2 Other
650 _ 7 |a cervical dystonia
|2 Other
650 _ 7 |a immunogenicity
|2 Other
650 _ 7 |a spasticity
|2 Other
650 _ 7 |a Botulinum Toxins, Type A
|0 EC 3.4.24.69
|2 NLM Chemicals
650 _ 7 |a Antibodies, Neutralizing
|2 NLM Chemicals
650 _ 7 |a Neuromuscular Agents
|2 NLM Chemicals
650 _ 7 |a abobotulinumtoxinA
|0 EC 3.4.24.69
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650 _ 7 |a incobotulinumtoxinA
|0 EC 3.4.24.69
|2 NLM Chemicals
650 _ 7 |a onabotulinum toxin A
|0 EC 3.4.24.69
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650 _ 2 |a Humans
|2 MeSH
650 _ 2 |a Botulinum Toxins, Type A: therapeutic use
|2 MeSH
650 _ 2 |a Botulinum Toxins, Type A: immunology
|2 MeSH
650 _ 2 |a Botulinum Toxins, Type A: adverse effects
|2 MeSH
650 _ 2 |a Muscle Spasticity: drug therapy
|2 MeSH
650 _ 2 |a Muscle Spasticity: immunology
|2 MeSH
650 _ 2 |a Torticollis: drug therapy
|2 MeSH
650 _ 2 |a Torticollis: immunology
|2 MeSH
650 _ 2 |a Treatment Failure
|2 MeSH
650 _ 2 |a Antibodies, Neutralizing: blood
|2 MeSH
650 _ 2 |a Antibodies, Neutralizing: immunology
|2 MeSH
650 _ 2 |a Neuromuscular Agents: immunology
|2 MeSH
650 _ 2 |a Neuromuscular Agents: therapeutic use
|2 MeSH
650 _ 2 |a Blepharospasm: drug therapy
|2 MeSH
650 _ 2 |a Blepharospasm: immunology
|2 MeSH
700 1 _ |a Albrecht, Phillipp
|b 1
700 1 _ |a Carr, Warner
|b 2
700 1 _ |a Hefter, Harald
|b 3
773 _ _ |a 10.1111/ene.70289
|g Vol. 32, no. 8, p. e70289
|0 PERI:(DE-600)2020241-6
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|t European journal of neurology
|v 32
|y 2025
|x 1351-5101
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