12-year experience of incobotulinumtoxinA use in neurological practice

Botulinumtoxin type A (BoNT-A) has been shown to be an effective proven modern method of treating various neurological conditions. IncobotulinumtoxinA is a purified BoNT-A, free from complexing proteins, a widely used in pediatric and adult practice with proven efficacy and a favorable safety profile. There is little real-world data of long-term use of incobotulinumtoxinA with documented outcomes in our country, which predisposed the current retrospective study. Objective : to analyze the 12-year routine use of incobotulinumtoxinA in clinical hospitals of the Department of Neurology of the Saratov State Medical University. Material and methods . Retrospective data of 312 patients with neurological conditions, treated with incobotulinumtoxinA during the period from 2013 to 2024 was analyzed. We analyzed nosological entities, the number of patients and injection cycles, average dosage, number, and types of adverse events (AEs) and reported cases of secondary nonresponse. Results . BoNT-A therapy was most used for post-stroke spasticity (n=81), cervical dystonia (CD; n=62), and blepharospasm (n=57). The largest number of injections cycles was 263 in patients with CD. The average dose of incobotulinumtoxinA was 200 U. AEs were observed in 68 cases (6.4%) and did not affect treatment outcomes. There were neither serious AEs nor cases of secondary nonresponse reported. BoNT-A injections with electroneuromyography and ultrasound guidance made injections technique more accurate and safer. Conclusion . Retrospective analysis has shown that incobotulinumtoxinA was most used for post-stroke spasticity, CD and blepharospasm. The low frequency of AEs and no signs of secondary treatment failure were noted.