Evidence map›Paper›PMID 30202071›Full record

ArticleEye (London, England)2019

Long-term outcome of flexible onabotulinum toxin A treatment in facial dystonia.

John C Bladen, Ilan Feldman, Maribel Favor, Marizol Dizon, Andre Litwin, Raman Malhotra

Open access · bronzeAbstract readComparative Study
In one paragraph

Article in Eye (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 29% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

John C BladenCorneo Plastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, UK. john.bladen1@nhs.net.
Ilan FeldmanCorneo Plastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, UK.
Maribel FavorCorneo Plastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, UK.
Marizol DizonCorneo Plastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, UK.
Andre LitwinCorneo Plastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, UK.
Raman MalhotraCorneo Plastic Unit, Queen Victoria Hospital NHS Trust, East Grinstead, UK.
Queen Victoria Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe purpose of this study was to assess the long-term outcome of onabotulinum used to treat facial dystonia and compare a flexible and fixed treatment regimen.

methodsThis was a retrospective comparative study looking at benign essential blepharospasm (BEB), hemifacial spasm (HFS) and aberrant facial nerve regeneration synkinesis (AFR) treatment with onabotulinum toxin A (Botox®) over a minimum of 10 years. Fifty-one patients were recruited into the study, with each dystonia subgroup having 17 patients. Blepharospasm disability score (BDS), subjective improvement score (SIS), duration of maximal effect (DME) and complications were recorded at each visit.

resultsThe mean age was 63 years and gender predominately female. Thirty-seven patients underwent flexible treatment intervals compared to 14 fixed treatment intervals, averaging 3.4 and 4 per annum, respectively. Mean BDS significantly improved from 6 to 3 at last review across all 3 groups, with the highest effect on BEB. BDS improvement was greater in flexible intervals. SIS remained similar for all three conditions during follow-up, but in those undergoing flexible intervals, SIS increased by a small margin compared to fixed interval. Mean DME was 10.5 weeks across all dystonias, but increased progressively only in the flexible interval group. Complications included ptosis (30%), dry eye (14%) and lagophthalmos (8%).

conclusionFlexible onabotulinum provided better long-term relief on BDS for facial dystonia than a fixed regimen. Flexible interval treatment may also provide better patient satisfaction and longer DME compared to fixed treatment. Both have similar complication rates. With flexible treatment however, fewer injections were required over 10 years, leading to cost saving.

Indexed as

AgedBlepharospasmBotulinum Toxins, Type ADisability EvaluationDose-Response Relationship, DrugDrug Administration ScheduleFemaleFollow-Up StudiesHemifacial SpasmHumansInjections, SubcutaneousMaleMiddle AgedNeuromuscular AgentsRetrospective StudiesTreatment OutcomeBotulinum Toxins, Type ANeuromuscular Agents

Identifiers

PMID30202071
PMCPMC6460690
OpenAlexW2890031744

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.