Objective: This study aimed to determine whether IncobotulinumtoxinA (IBTX) provides sustained efficacy as a treatment modality patients in both de-novo patients and patients converted from onabotulinutoxinA (OBTX).

Background: IBTX is a complexing protein free toxin that has been available in Canada since 2009. Since then, patients are being treated with this product. These patients have either been converted from OBTX to IBTX or have been initiated on IBTX for the first time (de-novo). To date, there have been no published post-market reports across multiple centers of the efficacy and tolerability of IBTX in routine use.

Methods: Data was collected from 5 sites in Canada (Halifax, Winnipeg, Cambridge, London, Windsor) with four separate investigators. Parameters of the data collected included all patients treated with IBTX in their treatment history. All data collection was completed in 3 months. Recorded data included last dose of OBTX before switch and all injections of IBTX until May 2015, general outcome (as noted by physician), patient condition, year of birth and retention on IBTX. Analysis included separation of patients by condition, total number of cases of each condition, average dosing of pre and post switch and de-novo conditions and calculation of statistical significance between dosages for de-novo and switched patients.

Results: A total of 382 charts (switched/de-novo/switch back to OBTX) were reviewed across cervical dystonia (84/86/18), blepharospasm (13/16/7), hemifacial spasm (13/17/3), spasticity (6/15/0), essential tremor (11/4/0), headache (9/7/3), Meige syndrome (6/1/0), Parkinson’s disease (3/16/1) and miscellaneous (9/33/0) indications. Eight percent of patients switched back to OBTX. Reasons for switch were varied including tolerance, coverage and efficacy. There was no statistically significant difference in dosing for any indication between the OBTX to IBTX. All de-novo patients remained on IBTX and had the same overall dose of IBTX as those that were on OBTX across all conditions.

Conclusions: Majority of patients switched from OBTX to IBTX remained on IBTX. Post switch dose did not increase in any indication for switched and de-novo IBTX suggesting dose equivalency between OBTX and IBTX. No de-novo patients were switched to OBTX after being treated with IBTX.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/multicentre-retrospective-chart-review-of-patients-treated-with-incobotulinumtoxina-to-evaluate-sustained-efficacy-and-tolerability-in-converted-and-de-novo-conditions/