SynthesisEuropean journal of neurology2025
Systematic Review and Meta-Analysis of Secondary Treatment Failure and Immunogenicity With Botulinum Neurotoxin A in Multiple Indications.
Synthesis in European journal of neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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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
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic Review and Meta-Analysis of Secondary Treatment Failure and Immunogenicity With Botulinum Neurotoxin A in Multiple Indications.European journal of neurology · 2025Pooled it
- Efficacy and Safety of IncobotulinumtoxinA for the Treatment of Blepharospasm: A Multicenter, Phase 3 Study in Japan.Toxins · 2026Trial
- Efficacy and Safety of a Tailored Dosing Strategy with High-Dose IncobotulinumtoxinA at Flexible Injection Intervals for Cervical Dystonia: An Open-Label, Uncontrolled, Single-Arm Study in Japan.Neurology international · 2026Article
- Benefits of Incobotulinumtoxin A in Pain, Spasticity and Functionality-A 5 Years Review.Toxins · 2026Article
- Observational
- Systematic Review and Meta-Analysis of Secondary Treatment Failure and Immunogenicity with Botulinum Neurotoxin A in Multiple Indications-Comment on Recommending IncobotulinumtoxinA as First-Line to Prevent Secondary Treatment Failure [Letter].European journal of neurology · 2026Article
- Article
- The use of Botulinum Toxin Type A in patients in out-of-hospital intensive care in Germany-results from a multidisciplinary online survey.Frontiers in neurology · 2025Article
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
Abstract
backgroundBotulinum 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.
methodsA 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.
resultsTwenty-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.
conclusionsThe 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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