Leblong Emilie, Piette Patrice, Anne Carole, Jeanne Maud, Poyau Marion, Roy Anne Laure, Gallien Philippe
Fondation Saint Helier, 35043 Rennes, France.
Toxins (Basel). 2025 Feb 24;17(3):103. doi: 10.3390/toxins17030103.
This retrospective study investigates botulinum toxin changes in 206 patients with spasticity, following reimbursement adjustments in France. The main objective was to evaluate the tolerance and efficacy of these changes, a topic underexplored due to the common practice of maintaining the same toxin brand. The majority of patients switched from Botox to Xeomin (73.66%), while others switched from Botox to Dysport (14.63%) or from Xeomin to Dysport (11.71%). Dose adjustments varied depending on the switch, with the change from Botox to Xeomin showing the greatest diversity in adjustments. Overall, tolerance was good, with few adverse effects reported, primarily fatigue. Perceived efficacy fluctuated, with some patients noting improvement while others experienced deterioration, but the median remained stable. A majority of patients (57.06%) chose to continue with their new treatment, indicating general satisfaction, though 42.93% preferred to return to their initial treatment. This study highlights the importance of an individualized approach and careful monitoring during toxin changes. The results suggest that toxin switches can be made without an increase in adverse effects. While differences between groups were observed, they were not statistically significant. Placebo and nocebo effects may influence perceptions of efficacy and side effects during treatment changes.
这项回顾性研究调查了法国报销政策调整后206例痉挛患者肉毒杆菌毒素的变化情况。主要目的是评估这些变化的耐受性和疗效，由于通常维持使用同一毒素品牌的做法，该主题尚未得到充分探索。大多数患者从保妥适（Botox）换用了司库奇尤单抗（Xeomin）（73.66%），而其他患者从保妥适换用了丽舒妥（Dysport）（14.63%）或从司库奇尤单抗换用了丽舒妥（11.71%）。剂量调整因换药情况而异，从保妥适换用司库奇尤单抗时调整的多样性最大。总体而言，耐受性良好，报告的不良反应很少，主要是疲劳。感知到的疗效有所波动，一些患者注意到有所改善，而另一些患者则病情恶化，但中位数保持稳定。大多数患者（57.06%）选择继续接受新治疗，表明总体满意，不过42.93%的患者更愿意恢复初始治疗。这项研究强调了在毒素更换期间采取个体化方法和仔细监测的重要性。结果表明，更换毒素不会增加不良反应。虽然观察到组间存在差异，但无统计学意义。安慰剂和反安慰剂效应可能会影响治疗更换期间对疗效和副作用的认知。
