SciELO - Scientific Electronic Library Online

vol.29 número1Medication overuse in Bucaramanga, Colombia: Prevalence and associated factorsNeuropsychological profile in patients with ischemic stroke of the left middle cerebral artery índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados




Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Não possue artigos similaresSimilares em SciELO
  • Em processo de indexaçãoSimilares em Google


Acta Neurológica Colombiana

versão impressa ISSN 0120-8748


PRADA G, Diana M. Botulinum Toxin Type B vs Type A in Cervical Dystonia: A Meta - analysis of high quality trials. Acta Neurol Colomb. [online]. 2013, vol.29, n.1, pp.27-35. ISSN 0120-8748.

Introduction: cervical dystonia (CD) is a frequent disabling condition. Botulinum Toxin (BT) type A is effective for CD. BT type B is an alternative, but its use for patients who develop neutralizing antibodies against BT type A is debatable. Objetive: the aim of this study was to compare the efficacy of BT type B (>5000 U) versus type A and placebo patients with CD. Materials and methods: we identified RCTs comparing interventions. Quality assessment was made according to Cochrane Collaboration. A pooled analysis was conducted for continuous and dichotomous data using a random effect model identifying OR -{CI95%, p < 0.05}-. Primary outcomes were improvement in TWSTRS until week sixteen. Secondary outcomes were adverse effects and costs. Results: five RCTs fulfilled inclusion criteria (217 patients treated with BT type B; 224 patients in placebo group or type A). Two trials compared BT type B versus type A and three versus placebo. Quality assessment showed high quality of trials. BT type B improved TWSTRS scores at 4 weeks versus placebo -{OR: 6.54 (CI 95%: 2.68 - 10.39; p<0.00001)}-. No significant difference in efficacy was found in BT type B versus type A patients -{OR:-2.16 (CI 95%:-2.64-1.88; p<0.0001)}-. At week sixteen, BT type B demonstrated a sustained efficacy versus placebo. Dry mouth was significantly more frequent with BT type B compared to BT type A. Adverse events such as dry mouth and dysphagia were significantly more frequent in the BT type B group when compared to placebo. There was no information about costs. Conclusions: no significant differences in safety and efficacy were found between BT type B when compared to type A in CD patients. BT type B is more frequently associated with dry mouth than the A serotype. More studies are needed to evaluate therapeutic options in type A resistant patients. Further evidence is required to evaluate the efficacy of BT types A and B prospectively.

Palavras-chave : Cervical Dystonia; Adults; Botulinum Toxin Type B; Botulinum Toxin Type A; Botulinum Toxin Type A Resistance; Placebo; Randomized Controlled Trials; Safety; Efficacy.

        · resumo em Espanhol     · texto em Inglês     · Inglês ( pdf )