SynthesisBMC neurology2014
Systematic review and meta-analysis of the duration of clinical effect of onabotulinumtoxinA in cervical dystonia.
Synthesis in BMC neurology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Deep brain stimulation in pediatric dystonia: a systematic review.Neurosurgical review · 2020Pooled it
- Treatment of cervical dystonia with Botox (onabotulinumtoxinA): Development, insights, and impact.Medicine · 2023Trial
- Knowledge and practice of deep brain stimulation among pediatric neurology residents in Saudi Arabia.Journal of medicine and life · 2025Article
- Review
- Overview of DaxibotulinumtoxinA for Injection: A Novel Formulation of Botulinum Toxin Type A.Drugs · 2021Review
- Article
- Medical and Surgical Treatments for Dystonia.Neurologic clinics · 2020Review
- Validation of a self-completed Dystonia Non-Motor Symptoms Questionnaire.Annals of clinical and translational neurology · 2019Article
- Injection of Onabotulinum Toxin A into the Bilateral External Oblique Muscle Attenuated Camptocormia: A Prospective Open-Label Study in Six Patients with Parkinson's Disease.Neurology and therapy · 2018Article
- Treatment satisfaction with botulinum toxin: a comparison between blepharospasm and cervical dystonia.Patient preference and adherence · 2017Article
- Pregnancy outcomes following exposure to onabotulinumtoxinA.Pharmacoepidemiology and drug safety · 2016Article
- Striving for more good days: patient perspectives on botulinum toxin for the treatment of cervical dystonia.Patient preference and adherence · 2016Article
- Diagnosis and treatment of dystonia.Neurologic clinics · 2015Review
- Patient considerations in the treatment of cervical dystonia: focus on botulinum toxin type A.Patient preference and adherence · 2015Review
- Systematic Review of Rehabilitation in Focal Dystonias: Classification and Recommendations.Movement disorders clinical practiceReview
- Injectable DaxibotulinumtoxinA in Cervical Dystonia: A Phase 2 Dose-Escalation Multicenter Study.Movement disorders clinical practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBotulinum toxins are considered first-line therapy for treatment of cervical dystonia (CD) and must be injected on a repeat basis. Understanding the duration of clinical benefit of botulinum toxins and its impact on health care utilization are thus important in the contemporary environment. However, there is currently no overall consensus on the duration of effect of onabotulinumtoxinA in the treatment of CD. We performed a systematic review and meta-analysis to identify the duration of effect of onabotulinumtoxinA in CD and investigate factors that may influence it.
methodsA systematic literature search identified prospective or retrospective studies reporting duration of effect of onabotulinumtoxinA for the treatment of CD. Inclusion criteria included peer-reviewed, non-review, English-language articles published between January 1980 and January 2013. A formal meta-analysis using Comprehensive Meta-Analysis Version 2 was conducted to identify the duration of effect of onabotulinumtoxinA in the treatment of CD; both fixed and random effects models were performed. Subgroup analyses were performed to identify factors that influenced the duration of effect of onabotulinumtoxinA.
resultsA total of 18 studies (including >1,900 patients) met the inclusion criteria and were used for the meta-analysis. The mean duration of effect of onabotulinumtoxinA in CD was found to be 93.2 days (95% CI 91.8-94.6 days) for the fixed effects model and 95.2 days (95% CI 88.9-101.4 days) for the random effects model. A meta-regression found that dose of onabotulinumtoxinA and country of origin influenced the duration of effect of onabotulinumtoxinA, whereas quality score of the article and study type did not. In particular, doses ≥180 Units were associated with longer durations of effect than doses <180 Units (107-109 days vs. 86-88 days, respectively; p < 0.01). Limitations included pooling studies that used discrete definitions of duration and had different designs and study quality.
conclusionsBased on the published literature, the mean duration of effect of onabotulinumtoxinA in CD was 93-95 days (13.2-13.5 weeks). This suggests that, in general, patients with CD treated with onabotulinumtoxinA should require ~4 treatments per year.
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