Evidence map›Paper›PMID 35842881›Full record

ArticleJournal of neurology2022

The complex relationship between antibody titers and clinical outcome in botulinum toxin type A long-term treated patients with cervical dystonia.

Harald Hefter, Beyza Ürer, Raphaela Brauns, Dietmar Rosenthal, Sven G Meuth, John-Ih Lee, Philipp Albrecht, Sara Samadzadeh

Open access · hybridAbstract read
In one paragraph

Article in Journal of neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 28% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. 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

8 authors at 1 institution in 1 country.

Harald HefterDepartment of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany. Harald.Hefter@online.de.ORCID http://orcid.org/0000-0003-1069-7684
Beyza ÜrerDepartment of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
Raphaela BraunsDepartment of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
Dietmar RosenthalDepartment of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
Sven G MeuthDepartment of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
John-Ih Lee *Department of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
Philipp Albrecht *Department of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
Sara Samadzadeh *Department of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
Heinrich Heine University Düsseldorf · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRepeated injections with abo- or onabotulinumtoxin type A (aboBoNT/A, onaBoNT/A) may lead to induction of neutralizing antibodies (NABs) and/or a secondary treatment failure (STF). The relation between NABs and STF is still unclear. AIM OF THE STUDY: To demonstrate that a significant improvement can be observed in patients with STF after abo- or onaBoNT/A-treatment when switched to incobotulinumtoxin type A (incoBoNT/A) and that in NAB-positive patients without STF abo- or onaBoNT/A-treatment can be continued without significant worsening.

methodsParalysis times (PT) of the mouse hemidiaphragm assay (MHDA) and clinical outcome (TSUI-score) was analyzed in 60 patients with cervical dystonia (CD) and STF after abo- or onaBoNT/A-treatment (STF-group) who were switched to incobotulinumtoxin type A (incoBoNT/A). These data were compared to those of 34 patients who were exclusively treated with incoBoNT/A (INCO-group). Furthermore, PTs and TSUI-scores were followed up over 7 years in 9 patients with NABs but without STF who were switched to inco-BoNT/A (SWI-group) and 9 other patients with NABs who remained on their previous BoNT/A preparation (NO-SWI-group).

resultsIn the STF-group, a significant improvement of TSUI-scores could be detected after switch to incoBoNT/A. This improvement was less pronounced than in the INCO-group. There was no significant difference in long-term outcome between the SWI- and NO-SWI-group.

conclusionThe best strategy is to avoid the induction of NABs. A switch to incoBoNT/A may lead to improvement in patients with STF. However, in some patients with NABs without STF, BoNT/A-treatment can be continued without significant worsening.

Indexed as

Botulinum Toxins, Type ANeuromuscular AgentsTorticollisAnimalsAntibodies, NeutralizingMiceTreatment FailureAntibodies, NeutralizingBotulinum Toxins, Type ANeuromuscular AgentsAntibody formationBotulinum toxin therapyCervical dystoniaCourse of the diseaseLong-term outcomeSecondary treatment failure

Identifiers

PMID35842881
PMCPMC9553769
OpenAlexW4285677185

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Registered trials

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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.