Neutralizing Antibodies and Long-Term Immunogenicity

Clinicians should consider using the lowest possible BoNT dose, especially in the neck region, and avoid unnecessary regimen switching.

Development of neutralizing antibody (NAB)–induced complete secondary treatment failure in recipients of long-term botulinum neurotoxin (BoNT) treatment is an important consideration for practitioners. To determine risk factors associated with development, investigators conducted a single-center retrospective assay for NABs in 173 recipients of BoNT drawn from two previous studies using the mouse hemidiaphragm test. In the cohort, 93 subjects with five dystonia subtypes had suspected BoNT failure. The researchers used a stepwise binary logistic regression analysis to identify independent risk factors for BoNT failure. These patients had a mean treatment duration of 9.8 years and a mean of 31 treatment cycles. Adherence to therapy in the coh…

Reviewing Author

Michael S. Okun, MD

Disclosures

Consultant/Advisory BoardParkinson’s Foundation; Tourette Association of America

Speaker’s BureauMedscape/WebMD CME, Movement Disorders Society CME, American Academy of Neurology CME

RoyaltiesBooks4Patients; Demos; Cambridge; Taylor and Francis; Robert Rose; Public Affairs

Grant/Research SupportNational Institutes of Health; Parkinson’s Foundation; Tourette Association of America; University of Florida Foundation

Editorial BoardsTremor and Other Hyperkinetic Movements; JAMA Neurology

Leadership Positions in Professional SocietiesParkinson’s Foundation (Medical Advisor)