Objective: To evaluate the safety and efficacy of incobotulinumtoxinA (IncoA) injection for treatment of Essential Tremor (ET).

Background: In essential tremor and Parkinson’s Disease tremor, administration of onabotulinumtoxinA via a fixed injection approach improves the tremor but a high percentage of patients (30-70%) develop moderate to severe hand weakness which has limited its use in clinical practice.

Methods: This study was performed from July 2013 to July 2016 on 33 subjects. This is a double-blind, placebo-controlled, crossover trial injecting 80-120 units of IncoA into 8-14 hand and forearm muscles using a customized approach. The subjects were followed for 28 weeks. The treatment efficacy was evaluated by the Fahn Tolosa Marin tremor rating score and NIH genetic criteria for tremor severity at 4 and 8 weeks after each of the two sets of treatments. Hand strength was assessed by an ergometer.

Results: There was a statistically significant improvement in clinical rating score of tremor at 4 and 8 weeks following the IncoA injection.

Conclusions: In this study, injection of IncoA treatment via a customized approach improved essential tremor on the clinical scales and patient’s perception with a low occurrence of significant hand weakness. Preliminary data was presented as a platform presentation at American Academy of Neurology (AAN 2016).

References: Brin MF, Lyons KE, Doucette J, et al. A randomized, double-masked, controlled trial of botulinum toxin type A in essential hand tremor. Neurology 2001;56:1523-8. Jankovic J, Schwartz K, Clemence W, et al. A randomized, double-blind, placebo-controlled study to evaluate botulinum toxin type A in essential hand tremor. Mov Disord 1996;11:250-6.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/botulinum-toxin-in-essential-hand-tremor-a-randomized-double-blind-placebo-controlled-study-with-customized-injection-approach/