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Botulinum toxin type A versus anticholinergics for cervical dystonia
J Costa1, C Espírito-Santo, A Borges
1Instituto de Farmacologia e Terapêutica Geral, Faculdade de Medicina Lisboa, Av. Prof. Egas Moniz, Lisboa, Portugal, 1649-028. movementdisord@mail.telepac.pt
The Cochrane Database of Systematic Reviews
|January 28, 2005
Summary
Botulinum toxin Type A (BtA) injections offer superior benefits for cervical dystonia compared to anticholinergic drugs like trihexyphenidyl. BtA was also better tolerated, suggesting it as a preferred treatment option.
Area of Science:
- Neurology
- Movement Disorders
Background:
- Cervical dystonia, a common focal dystonia, causes involuntary head posturing and neck pain.
- It often leads to disability and social withdrawal, typically being a lifelong condition.
- Botulinum toxin Type A (BtA) is the current first-line therapy, replacing older anticholinergic treatments.
Purpose of the Study:
- To compare the clinical efficacy and safety of Botulinum toxin Type A (BtA) versus anticholinergic drugs for cervical dystonia treatment.
Main Methods:
- Searched multiple databases (Cochrane, MEDLINE, EMBASE) up to June 2003.
- Included randomized studies comparing BtA with anticholinergic drugs.
- Two reviewers independently assessed trial quality and extracted data, contacting authors for additional information.
Main Results:
- Only one trial met inclusion criteria, comparing BtA with trihexyphenidyl in 66 patients.
- Results favored BtA, showing clinically significant benefits comparable to BtA vs. placebo.
- Botulinum toxin Type A (BtA) demonstrated better tolerability than trihexyphenidyl.
Conclusions:
- Botulinum toxin Type A (BtA) injections provide greater objective and subjective benefits for cervical dystonia than trihexyphenidyl.
- Further research is needed on anticholinergic drugs for patients unresponsive to BtA.