Treatment response to onabotulinumtoxinA in cervical dystonia patients with anterocollis and retrocollis.

Anterocollis (AC) and retrocollis (RC) are less common cervical dystonia (CD) subtypes that are often under-represented in CD clinical trials. Herein we describe real-world demographics, disease characteristics, and treatment response to onabotulinumtoxinA (onabotA) in AC or RC patients from an observational, multicenter, prospective registry, CD PROBE. After three onabotA treatments, outcomes (CDIP-58, PGIC, CGIC, CD severity, TWSTRS) in patients with predominant AC or RC were compared to torticollis (TC) and all CD subtypes combined. The mean dosages at each treatment ranged from 153.5 to 195.4 U (AC) to 184.0-213.4 U (RC). After treatment, AC and RC patients reported improvements in the CDIP-58. "Much" or "very much improved" on PGIC and CGIC was reported by AC patients (n = 11/23, 48%) and clinicians (n = 14/23, 61%); and by RC patients (n = 14/24, 58%) and clinicians (n = 19/24, 83%). The mean total TWSTRS decreased from 45.7 (n = 59) to 36.1 (n = 23, 21.0% improvement) for AC patients and from 40.1 (n = 55) to 31.6 (n = 23, 21.2% improvement) for RC patients; the proportion of AC and RC patients with severe CD decreased. Outcomes for AC and RC were generally consistent with those for TC and all subtypes combined. Dysphagia was reported in 4/59 (6.8%) of AC patients (one serious), 7/55 (12.7%) of RC patients (none serious), 29/494 (5.9%) of TC patients (none serious), and 64/1012 (6.3%) of all CD patients (two serious). No new safety signals were identified. In conclusion, treatment with onabotA may relieve CD symptoms in some patients with AC and RC, consistent with results for other CD subtypes and the known safety profile of onabotA for the treatment of CD.
Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Marc Schwartz reports financial support was provided by AbbVie Inc. Khashayar Dashtipour reports article publishing charges and writing assistance were provided by AbbVie Inc. Khashayar Dashtipour reports a relationship with AbbVie Inc that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with Ipsen that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with Supernus Pharmaceuticals Inc that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with Teva Pharmaceuticals USA Inc that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with Neurocrine Biosciences Inc that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with Acorda Therapeutics Inc that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with Sunovion Respiratory Development Inc that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with ACADIA Pharmaceuticals Inc that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with Avion Pharmaceuticals that includes: consulting or advisory. Khashayar Dashtipour reports a relationship with Revance Therapeutics that includes: consulting or advisory. David Charles reports a relationship with AbbVie Inc that includes: consulting or advisory. David Charles reports a relationship with Merz Pharmaceuticals LLC that includes: consulting or advisory. David Charles reports a relationship with GlaxoSmithKline Inc that includes: consulting or advisory. David Charles reports a relationship with Newronika that includes: consulting or advisory. David Charles reports a relationship with Supernus Pharmaceuticals Inc that includes: consulting or advisory. David Charles reports a relationship with Ipsen that includes: consulting or advisory. David Charles reports a relationship with Iota that includes: consulting or advisory. David Charles reports a relationship with Abbott that includes: consulting or advisory. David Charles reports a relationship with Alliance for Patient Access that includes: consulting or advisory. Shyamal Mehta reports a relationship with AbbVie Inc that includes: consulting or advisory. Shyamal Mehta reports a relationship with Abbott that includes: consulting or advisory. Shyamal Mehta reports a relationship with Adamas Pharmaceuticals Inc that includes: consulting or advisory. Hubert H. Fernandez reports a relationship with Biogen that includes: funding grants. Hubert H. Fernandez reports a relationship with Cerevel Therapeutics Inc that includes: funding grants. Hubert H. Fernandez reports a relationship with The Michael J Fox Foundation that includes: funding grants. Hubert H. Fernandez reports a relationship with National Institutes of Health that includes: funding grants. Hubert H. Fernandez reports a relationship with Parkinson Study Group that includes: consulting or advisory. Hubert H. Fernandez reports a relationship with Parkinson's Foundation Inc that includes: funding grants. Hubert H. Fernandez reports a relationship with Roche that includes: funding grants. Hubert H. Fernandez reports a relationship with Cleveland Clinic that includes: speaking and lecture fees. Hubert H. Fernandez reports a relationship with Amneal Pharmaceuticals LLC that includes: consulting or advisory. Hubert H. Fernandez reports a relationship with Amneal Pharmaceuticals LLC that includes: consulting or advisory. Hubert H. Fernandez reports a relationship with AbbVie Inc that includes: consulting or advisory. Hubert H. Fernandez reports a relationship with Cerevel Therapeutics Inc that includes: consulting or advisory. Hubert H. Fernandez reports a relationship with Neurocrine Biosciences Inc that includes: consulting or advisory. Hubert H. Fernandez reports a relationship with Parkinson Study Group that includes: consulting or advisory. Hubert H. Fernandez reports a relationship with ELSEVIER INC that includes: employment. Hubert H. Fernandez reports a relationship with Springer that includes: employment. Joseph Jankovic reports a relationship with AbbVie Inc that includes: funding grants. Joseph Jankovic reports a relationship with CHDI Foundation that includes: funding grants. Joseph Jankovic reports a relationship with Dystonia Coalition that includes: funding grants. Joseph Jankovic reports a relationship with Emalex Biosciences that includes: funding grants. Joseph Jankovic reports a relationship with Medtronic that includes: funding grants. Joseph Jankovic reports a relationship with The Michael J Fox Foundation that includes: funding grants. Joseph Jankovic reports a relationship with Parkinson's Foundation Inc that includes: funding grants. Joseph Jankovic reports a relationship with Revance Therapeutics that includes: funding grants. Joseph Jankovic reports a relationship with Teva PharmaceuticalsUSA Inc that includes: funding grants. Joseph Jankovic reports a relationship with AbbVie Inc that includes: consulting or advisory. Joseph Jankovic reports a relationship with Aeon BioPharma that includes: consulting or advisory. Joseph Jankovic reports a relationship with Neurocrine Biosciences Inc that includes: consulting or advisory. Joseph Jankovic reports a relationship with Revance Therapeutics that includes: consulting or advisory. Joseph Jankovic reports a relationship with Teva Pharmaceuticals USA Inc that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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