Session Information
Date: Thursday, June 23, 2016
Session Title: Dystonia
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To prospectively assess the interval in weeks between injection of botulinum toxin A (BoNTA) and patient-perceived need for the next injection for treatment of cervical dystonia (CD).
Background: BoNT is the treatment of choice for CD. Current treatment practice is to allow an interval of at least 12 weeks between injections. This was based on early concerns of immunoresistance when older preparations of BoNTA were administered. With modern BoNT formulations, the occurrence of immunoresistance has been markedly reduced. However, reimbursement for treatment remains anchored to the 12 week interval despite recurrence of symptoms at shorter intervals in some CD patients.
Methods: Patients with isolated CD with at least 2 previous beneficial BoNTA injections were recruited and evaluated during their regular BoNTA injection visits using the Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS). Following the injection, patients completed weekly electronic diaries indicating each week whether their CD symptoms had recurred, and whether they would desire an injection at that time and the symptom of CD that was determining this.
Results: 89 CD patients were enrolled, 65 used the weekly diaries (70% women, mean age 57 (SD 15) years, mean CD duration 13 (SD 9) years, median baseline TWSTRS motor severity score 15 (SD 5). Of these, 6 patients did not benefit from injection and would desire reinjection prior to 4 weeks. Of those with benefit, 27% indicated the need for injection at </= 6 weeks, and 42% indicated need for injection at </= 10 weeks.
Conclusions: This study demonstrates that almost half of CD patients receiving regular injections felt the need for reinjection before the prescribed 3 month interval. Providing CD patients with a more flexible injection interval may improve outcomes from BoNT treatment. A limitation of this study method was participant fatigue resulting in a variable compliance with the weekly emails.
To cite this abstract in AMA style:
C.L. Vaughan, G.T. Stebbins, C.L. Comella. Assessment of need for treatment with botulinum toxin type A in cervical dystonia patients [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/assessment-of-need-for-treatment-with-botulinum-toxin-type-a-in-cervical-dystonia-patients/. Accessed May 13, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/assessment-of-need-for-treatment-with-botulinum-toxin-type-a-in-cervical-dystonia-patients/