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阿柏毒素A以500单位/1毫升和500单位/2毫升的稀释度为颈部肌张力障碍的治疗提供了灵活性。

AbobotulinumtoxinA provides flexibility for the treatment of cervical dystonia with 500 U/1 mL and 500 U/2 mL dilutions.

作者信息

Lew Mark F, Hauser Robert A, Isaacson Stuart H, Truong Daniel, Patel Atul T, Brashear Allison, Ondo William, Maisonobe Pascal, Dashtipour Khashayar, Bahroo Laxman, Wietek Stefan

机构信息

Department of Neurology, Keck/University of Southern California School of Medicine, Los Angeles, CA 90033, USA.

University of South Florida, Parkinson's Disease and Movement Disorders Center of Excellence, Tampa, FL 33613, USA.

出版信息

Clin Park Relat Disord. 2021 Nov 20;5:100115. doi: 10.1016/j.prdoa.2021.100115. eCollection 2021.

Abstract

INTRODUCTION

Cervical dystonia (CD) is a neurologic movement disorder with potentially disabling effects and significant impact on quality of life of those affected. AbobotulinumtoxinA (aboBoNT-A) was initially approved for a dilution of 500 U/1 mL and subsequently for a dilution of 500 U/2 mL, providing flexibility for clinicians to treat CD. Here, we explore the safety and efficacy of the 500 U/2 mL dilution versus 500 U/1 mL dilution of aboBoNT-A in a retrospective analysis based on published clinical trial data.

METHODS

The safety and efficacy of aboBoNT-A in patients with CD was evaluated in three multicenter, double-blind, randomized, placebo-controlled trials and open-label extensions. Trials 1 (NCT00257660) and 2 (NCT00288509) evaluated the 500 U/1 mL dilution in 80 and 116 patients, respectively; Trial 3 (NCT01753310) evaluated the 500 U/2 mL dilution in 125 patients.

RESULTS

Comparison of the adjusted mean difference in TWSTRS total scores at Week 4 from baseline for aboBoNT-A in Trial 1 (-6.0; 95% CI, -10.8, -1.3), Trial 2 (-8.8; 95% CI, -12.9, -4.7), and Trial 3 (-8.7; 95% CI, -13.2, -4.2) showed similar, significant improvements. Dysphagia and muscle weakness patterns were comparable across the three trials, indicating that an increased dilution of aboBoNT-A does not result in an increased risk of diffusion-related adverse events.

CONCLUSION

The results of these trials show that aboBoNT-A is similarly efficacious using either dilution, with similar safety and tolerability across trials. Having the 500 U/1 mL and 500 U/2 mL dilution volumes available provides further flexibility in administration, benefiting patient care.

摘要

引言

颈部肌张力障碍(CD)是一种神经运动障碍,可能导致残疾,并对患者的生活质量产生重大影响。阿柏西普肉毒素A(aboBoNT-A)最初获批的稀释浓度为500 U/1 mL,随后又获批了500 U/2 mL的稀释浓度,为临床医生治疗CD提供了灵活性。在此,我们基于已发表的临床试验数据进行回顾性分析,探讨500 U/2 mL稀释浓度与500 U/1 mL稀释浓度的aboBoNT-A的安全性和有效性。

方法

在三项多中心、双盲、随机、安慰剂对照试验及开放标签扩展试验中评估了aboBoNT-A对CD患者的安全性和有效性。试验1(NCT00257660)和试验2(NCT00288509)分别对80例和116例患者评估了500 U/1 mL的稀释浓度;试验3(NCT01753310)对125例患者评估了500 U/2 mL的稀释浓度。

结果

试验1(-6.0;95%CI,-10.8,-1.3)、试验2(-8.8;95%CI,-12.9,-4.7)和试验3(-8.7;95%CI,-13.2,-4.2)中,aboBoNT-A在第4周时与基线相比的TWSTRS总分调整后平均差异比较显示出相似的显著改善。三项试验中吞咽困难和肌肉无力模式具有可比性,表明aboBoNT-A稀释浓度增加不会导致扩散相关不良事件风险增加。

结论

这些试验结果表明,两种稀释浓度的aboBoNT-A疗效相似,试验中的安全性和耐受性也相似。500 U/1 mL和500 U/2 mL稀释浓度的存在为给药提供了更大的灵活性,有利于患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0be/8636802/0e78ce2103fd/gr1.jpg

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