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Comparison of efficacy and immunogenicity of original versus current botulinum toxin in cervical dystonia

From the Parkinson’s Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, TX.

Address correspondence and reprint requests to Dr. Joseph Jankovic, Professor of Neurology, Director of Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, 6550 Fannin, Suite 1801, Houston, TX 77030; e-mail: josephj{at}bcm.tmc.edu

The authors compared 130 patients treated for cervical dystonia with original botulinum toxin (BTX) type A (Botox; Allergan, Inc., Irvine, CA), 42 of whom were exposed only to the original BTX type A used before 1998 (25 ng protein/100 units), and 119 treated only with the current BTX type A (5 ng of protein/100 units). Blocking antibodies were detected in 4 of 42 (9.5%) patients treated only with original BTX type A but in none of the 119 patients treated exclusively with current BTX type A (p < 0.004). The current preparation decreased the risk of antibody formation by a factor of six. The authors conclude that the low risk of antibody formation after current BTX type A treatment is related to lower protein load.

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