Edmond J. Safra Program in Parkinson's Disease, Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, UHN, Toronto, ON M5T2S8, Canada.
Division of Neurology, University of Toronto, Toronto, ON M5S 3H2, Canada.
Toxins (Basel). 2020 Jul 24;12(8):470. doi: 10.3390/toxins12080470.
Cervical dystonia (CD) is a neurological movement disorder characterized by sustained involuntary muscle contractions. First-line therapy for CD is intramuscular injections of botulinum neurotoxin (e.g., abobotulinumtoxinA) into the affected muscles. The objective of this systematic literature review is to assess the clinical evidence regarding the effects of abobotulinumtoxinA for treatment of CD in studies of safety, efficacy, patient-reported outcomes, and economic outcomes. Using comprehensive electronic medical literature databases, a search strategy was developed using a combination of Medical Subject Heading terms and keywords. Results were reviewed by two independent reviewers who rated the level of evidence. The search yielded 263 publications, of which 232 were excluded for being duplicate publications, not meeting the selection criteria, or failing to meet predefined eligibility criteria, leaving a total of 31 articles. Clinical efficacy, patient-reported outcomes, and safety data were in 6 placebo-controlled trials (8 articles), 6 active-controlled trials, and 16 observational studies (17 articles). Data on health economic outcomes were provided in one of the clinical trials, in two of the observational studies, and in one specific cost-analysis publication. This review demonstrated that the routine use of abobotulinumtoxinA in CD is well-established, effective, and generally well-tolerated, with a relatively low cost of treatment.
颈部肌张力障碍 (CD) 是一种以持续性非自愿肌肉收缩为特征的神经运动障碍。CD 的一线治疗方法是将肉毒神经毒素（例如，阿 BotulinumtoxinA）肌肉内注射到受影响的肌肉中。本系统文献综述的目的是评估关于 abobotulinumtoxinA 治疗 CD 的安全性、疗效、患者报告的结果和经济结果的临床证据。使用全面的电子医学文献数据库，使用医学主题词和关键词的组合开发了搜索策略。结果由两名独立审查员进行审查，他们对证据水平进行了评分。该搜索产生了 263 篇出版物，其中 232 篇因重复出版物、不符合选择标准或不符合预先确定的资格标准而被排除在外，总共留下 31 篇文章。临床疗效、患者报告的结果和安全性数据来自 6 项安慰剂对照试验（8 篇文章）、6 项活性对照试验和 16 项观察性研究（17 篇文章）。一项临床试验、两项观察性研究和一项特定的成本分析出版物提供了健康经济学结果数据。本综述表明，阿 BotulinumtoxinA 在 CD 中的常规使用已得到充分确立，有效且通常耐受性良好，治疗成本相对较低。
