Evidence-based review and assessment of botulinum neurotoxin for the treatment of movement disorders.

摘要: Botulinum neurotoxin (BoNT) can be injected to achieve therapeutic benefit across a large range of clinical conditions. To assess the efficacy and safety BoNT injections for treatment certain hypersecretory disorders, including hyperhidrosis, sialorrhea, chronic rhinorrhea, an expert panel reviewed evidence from published literature. Data sources included English-language studies identified via MEDLINE, EMBASE, CINAHL, Current Contents, Cochrane Central Register Controlled Trials. Evidence tables generated in 2008 Report Therapeutics Technology Assessment Subcommittee American Academy Neurology (AAN) review use autonomic disorders were also updated. The evaluated at several levels, supporting as class, serotypes BoNT-A BoNT-B, well four individual commercially available formulations: abobotulinumtoxinA (A/Abo), onabotulinumtoxinA (A/Ona), incobotulinumtoxinA (A/Inco), rimabotulinumtoxinB (B/Rima). ultimately made recommendations each indication, based upon strength following AAN classification scale. For axillary hyperhidrosis total 923 patients, supported Level A recommendation BoNT-A, with B A/Abo A/Ona U (insufficient data) A/Inco B/Rima. Five trials 82 patients palmar C BoNT-B; formulations received rating due insufficient data. (and all formulations) gustatory sweating. Support sialorrhea was derived eight 222 adults children. A/Abo, A/Ona, B/Rima A/Inco. allergic rhinitis, on two Class II 73 patients. lack A/Inco, or those formulations. Further clarity optimal mode administration additional using other are needed fill current gaps.