[Botulinum toxin type B in the management of XXXX non-responsive to botulinum toxin type A].

@entity1 @entity3520 @entity24008 @entity2133 @entity158 @entity9663 @entity3519 @entity1736 @entity18711 @entity4676
BACKGROUND: Botulinum toxin (BTX) injection is the first choice treatment for @entity3520 . However 10% or more of @entity1 who receive repetitive injections of BTX type A (BTX-A) lose response (secondary non-responders). One of the strategies to manage such @entity1 is to treat them with another serotype. The aim of this article is to describe my experience with BTX type B ( @entity24008 ) in the management of @entity1 with @entity3520 who became secondary non-responders to BTX-A. METHOD: Open-label non-controlled use of @entity24008 injections to treat @entity3519 @entity1 who developed secondary nonresponse to BTX-A Response to treatment was rated on a 0-4 scale (Jankovic). RESULTS: Four @entity1 entered the study. Pacient 1- At age 48 this @entity1 developed @entity3520 . Five years later he also presented with @entity9663 and @entity18711 . He was treated with 7604U of BTX-A along 23 sessions separated by a mean interval of 18.8 weeks (range 6-39). Loss of response was noticed after the seventh session. First treatment with @entity24008 consisted of injection of 20000U with response rated 3 but duration of 3 weeks. Second session, 23500U, resulted in score 4 with response lasting 12 weeks. @entity1 2- This @entity1 , with @entity4676 since age 8 years, developed tardive @entity9663 at age 51. On 8 sessions of BTX-A injections he received a cumulative dosage of 550U with a mean interval between sessions of 8.8 weeks (range 6-12). Decline of response was noticed after the fifth session. First treatment with @entity24008 , 3000U, had a response rated 3 with duration of 12 weeks. Second session, 6000U, resulted in score 4. @entity1 3- This @entity1 noticed onset of @entity9663 at age 58 and developed oromandibular and @entity3519 as well as cervical @entity3519 , respectively, at ages 59 and 65. In other institutions she received 6 sessions of BTX-A. In my service she received a dosage of 1404U along 8 sessions with a mean interval between sessions of 17.4 weeks (range 16-18). She became secondary non-responder after the ninth session. First treatment with @entity24008 , 6000U, was rated 0. Second session, 12000U, was rated 4. @entity1 4- At age 69 this @entity1 developed @entity3520 . Prior to follow up with me, he received 6 sessions of BTX-A in other services. In my institution he was treated with a cumulative dosage of 730U along 4 sessions with a mean interval between sessions of 16.3 weeks (range 15-18). He developed loss of response on the sixth session. Treatment with @entity24008 , 12000U, was rated 4 and lasted 20 weeks. Side-effects: @entity158 (all @entity1 ) and @entity2133 and @entity1736 (one @entity1 each). CONCLUSION: My findings confirm that @entity24008 injections are a safe and effective option for the management of @entity3519 @entity1 who become secondary non-responders to BTX-A. The results also underscore the need of individualizing dosage regimens before optimum results are achieved.
