Table 3.
Five Case Studies of Patients Developing Neutralizing Antibodies After Botulinum Toxin Type A Injection for Aesthetic Use49
| Parameter | Patients receiving BoNT-A | ||||
|---|---|---|---|---|---|
| 1 | 2 | 3 | 4 | 5 | |
| Aesthetic indication | Upper face | Various sites over face | Hyperhidrosis | Various sites over face | Upper face |
| BoNT-A therapy | ONA No response so switched to ABO after 1 treatment | ABO for 13 months Declining response so switched to ONA for 3 months, then ABO for 4 weeks, then INCO after 9 months | 3 treatments of ONA with declining duration of treatment effect (from 5 to 2-3 months) Switched to ABO (duration of effect 1.5 months) | ABO over period of 8 years | 3 treatments of ABO over 2 years |
| Duration of treatment effect | 3 months | ~13 months | Declining from 5 months to 1.5 months | For first 3 years: 6-8 months Thereafter <3 months | Initially 6 months, then 2 months and then no response |
| Presence of neutralizing antibodies confirmed mouse phrenic nerve HDA | Yes (low positive) | Yes | Yes | Yes (high positive) | Yes (high positive) |
ABO, abobotulinumtoxinA; HDA, hemidiaphragm assay; INCO, incobotulinumtoxinA; ONA, onabotulinumtoxinA.