Publicação
Botulinum toxin type B for cervical dystonia : systematic review
| Resumo: | Background: This is an update of a previous review (Costa 2004). Cervical dystonia is a frequent and disabling disorder characterized by painful involuntary posturing of the head. Botulinum toxin type A (BtA) is the first line therapy for this condition, although Botulinum toxin type B (BtB) is an alternative option. Objectives: To compare the efficacy and safety of BtB versus placebo in cervical dystonia. Search methods: Cochrane Movement Disorders Group trials register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, reference lists of articles and conference proceedings. In addition, we contacted pharmaceutical companies. Selection criteria: Randomised placebo-controlled trials (RCTs) assessing efficacy and safety of BtB in cervical dystonia. Main results: We included 4 studies (n = 441) with an overall moderate methodological quality. BtB was associated with an improvement of 15% in the patients’ baseline clinical status as assessed by investigators, reducing 7 points in TWSTRS-total score at week 4 (95% CI: 4.43 to 9.01). Mean difference in TWSTRS-pain score at week 4 was 2.41 (95% CI: 0.82 to 4.01). Subjective clinician and patient assessments of change favoured BtB over placebo. BtB-treated patients had a 7.65 (95% CI: 2.75 to 21.32) and a 6.78 (95% CI: 2.42 to 19.05) increased risk of dry mouth and dysphagia, respectively. |
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| Autores principais: | Marques, Ana Raquel Esteves |
| Assunto: | Toxinas Botulínicas Clostridium botulinum Clostridium botulinum tipo B Distonia cervical |
| Ano: | 2015 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | inglês |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Background: This is an update of a previous review (Costa 2004). Cervical dystonia is a frequent and disabling disorder characterized by painful involuntary posturing of the head. Botulinum toxin type A (BtA) is the first line therapy for this condition, although Botulinum toxin type B (BtB) is an alternative option. Objectives: To compare the efficacy and safety of BtB versus placebo in cervical dystonia. Search methods: Cochrane Movement Disorders Group trials register, Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, reference lists of articles and conference proceedings. In addition, we contacted pharmaceutical companies. Selection criteria: Randomised placebo-controlled trials (RCTs) assessing efficacy and safety of BtB in cervical dystonia. Main results: We included 4 studies (n = 441) with an overall moderate methodological quality. BtB was associated with an improvement of 15% in the patients’ baseline clinical status as assessed by investigators, reducing 7 points in TWSTRS-total score at week 4 (95% CI: 4.43 to 9.01). Mean difference in TWSTRS-pain score at week 4 was 2.41 (95% CI: 0.82 to 4.01). Subjective clinician and patient assessments of change favoured BtB over placebo. BtB-treated patients had a 7.65 (95% CI: 2.75 to 21.32) and a 6.78 (95% CI: 2.42 to 19.05) increased risk of dry mouth and dysphagia, respectively. |
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