No Secondary Treatment Failure during Incobotulinumtoxin—A Long-Term Treatment Demonstrated by the Drawing of Disease Severity

The aim of this study was to detect clinical hints regarding the development secondary treatment failure (STF) in patients with focal dystonia who were exclusively treated incobotulinumtoxin/A (incoBoNT/A). In total, 33 outpatients (26 idiopathic cervical dystonia, 4 Meige syndrome and 3 other cranial dystonia) repeated injections incoBoNT/A for a mean period 6.4 years without interruptions recruited draw course their disease severity (CoD) from onset symptoms BoNT therapy (CoDB graph) recruitment (CoDA graph). At time recruitment, assessed change as percentage at therapy. Blood samples taken test presence neutralizing antibodies (NABs) using mouse hemidiaphragm assay (MHDA). Patients reported an improvement about 70% respect mean. None tested positive MHDA. Three different types CoDB three CoDA graphs could be distinguished. long-term outcomes, but there no significant difference outcomes between graphs. produced graph initial worsening hint STF. A primary non-response not observed any patients. During BoNT/A, NABs and/or STF may develop. However, present on monotherapy, or detected, underlining low antigenicity incoBoNT/A.