Kaji Ryuji, Endo Akira, Sugawara Michiko, Ishii Mika
National Hospital Organization Utano National Hospital, 8 Narutaki Ondoyama-cho, Ukyo-ku, Kyoto, Japan.
Institute of Health Biosciences, Tokushima University Graduate School, 3-18-15 Kuramotocho, Tokushima, Japan.
eNeurologicalSci. 2021 Oct 27;25:100374. doi: 10.1016/j.ensci.2021.100374. eCollection 2021 Dec.
To date, efficacy data on botulinum toxin type B (rimabotulinumtoxinB) in patients with cervical dystonia (CD) previously treated with botulinum toxin type A in a large population are lacking; thus, we aimed to evaluate type B efficacy in this patient population. In a post-marketing observational cohort study, 150 patients previously treated with botulinum toxin type A were enrolled, of whom 138 were followed up for 1 year after the initial type B injection. Final observation data were available for 122 patients. Efficacy was evaluated using the Toronto Western Spasmodic Torticollis Rating Scale. Total score improved from 39.9 at baseline to 34.3 at 4 weeks after the first injection, and pain score improved from 8.9 to 7.9. Improvements were maintained through six further injections in two subpopulations: patients who showed resistance to botulinum toxin type A and patients who were not type A resistant but switched to type B. For a number of patients, even low doses (<5000 units) of botulinum toxin type B demonstrated efficacy. These findings support the efficacy of botulinum toxin type B in clinical settings for the management of CD symptoms, including pain, even at low doses, regardless of the patient's botulinum toxin type A resistance status.
迄今为止，在大量人群中，关于先前接受过A型肉毒毒素治疗的颈部肌张力障碍（CD）患者使用B型肉毒毒素（利美布托毒素B）的疗效数据尚不充分；因此，我们旨在评估B型肉毒毒素在这类患者群体中的疗效。在一项上市后观察性队列研究中，纳入了150例先前接受过A型肉毒毒素治疗的患者，其中138例在首次注射B型肉毒毒素后接受了1年的随访。122例患者有最终观察数据。使用多伦多西部痉挛性斜颈评定量表评估疗效。总分从基线时的39.9分改善至首次注射后4周时的34.3分，疼痛评分从8.9分改善至7.9分。在两个亚组中，经过另外6次注射后，改善情况得以维持：对A型肉毒毒素耐药的患者以及不对A型肉毒毒素耐药但改用B型肉毒毒素的患者。对于许多患者而言，即使低剂量（<5000单位）的B型肉毒毒素也显示出疗效。这些发现支持了B型肉毒毒素在临床环境中治疗CD症状（包括疼痛）的疗效，即使是低剂量，且与患者对A型肉毒毒素的耐药状态无关。
