Neutralizing Botulinum Toxin Type A Antibodies: Clinical Observations in Patients with Cervical Dystonia

Jens D. Rollnik, MD,
Kai Wohlfarth, MD,
Reinhard Dengler, MD,
and Hans Bigalke, MD

Published: July 2001

Neutralization of antibodies poses a problem for a substantial number of cervical dystonia (CD) patients treated with botulinum toxin type A (BoNT/A). Pres- ence of these antibodies may lead to a secondary nonresponse to BoNT/A treatment.In this study, we compared 6 antibody-positive (Ab+) with 12 antibody- negative (Ab –) CD patients treated with BoNT/A (Dysport ®) and matched for du- ration of treatment, number of BoNT/A injections, and severity of clinical symptoms.The two groups differed in cumulative BoNT/A dose (Ab+, 5984 mouse units [MU ], SD =3151 MU;Ab –, 3143 MU, SD =1294 MU;P <.05).in addition, ab+ patients were significantly younger (ab+ mean age =41.3 y, sd =5.9 y;ab – mean age =56.8 y, sd =15.3 y;p <.05). in or- der to avoid formation of neutralizing antibodies, doses of bont/a should be kept as low as possible.the risk of antibody formation seems to be higher in younger patients.

Keywords: botulinum toxin type A (BoNT/A), antibodies, cervical dystonia (CD), therapy