Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus
Issued Date
2022-06-20
Resource Type
eISSN
21697574
Scopus ID
2-s2.0-85133399040
Journal Title
Plastic and Reconstructive Surgery - Global Open
Volume
10
Issue
6
Rights Holder(s)
SCOPUS
Bibliographic Citation
Plastic and Reconstructive Surgery - Global Open Vol.10 No.6 (2022) , E4407
Suggested Citation
Ho W.W.S., Albrecht P., Calderon P.E., Corduff N., Loh D., Martin M.U., Park J.Y., Suseno L.S., Tseng F.W., Vachiramon V., Wanitphakdeedecha R., Won C.H., Yu J.N.T., Dingley M. Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus. Plastic and Reconstructive Surgery - Global Open Vol.10 No.6 (2022) , E4407. doi:10.1097/GOX.0000000000004407 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/87290
Title
Emerging Trends in Botulinum Neurotoxin A Resistance: An International Multidisciplinary Review and Consensus
Author's Affiliation
Siriraj Hospital
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
St. Luke's Medical Center Quezon City
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Faculty of Medicine Ramathibodi Hospital, Mahidol University
University of Ulsan College of Medicine
The Cosmetic Medicine Centre
Retired
Taoyuan Milano Aesthetic Clinic
Apkoo-Jung Oracle Dermatology Clinic
Cosmetic Refinement Clinic
David Loh Surgery
JY Dermatology and Aesthetic Center
Central
Heinrich-Heine-Universität Düsseldorf Medizinische Fakultät
St. Luke's Medical Center Quezon City
Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo
Faculty of Medicine Ramathibodi Hospital, Mahidol University
University of Ulsan College of Medicine
The Cosmetic Medicine Centre
Retired
Taoyuan Milano Aesthetic Clinic
Apkoo-Jung Oracle Dermatology Clinic
Cosmetic Refinement Clinic
David Loh Surgery
JY Dermatology and Aesthetic Center
Central
Other Contributor(s)
Abstract
Background: Botulinum neurotoxin A (BoNT-A) injection is the most widely performed aesthetic procedure and a first-line therapeutic option for various medical conditions. The potential for BoNT-A immunoresistance and secondary nonresponse related to neutralizing antibody (NAb) formation warrants attention as the range of BoNT-A aesthetic applications continues to expand. Methods: An international multidisciplinary panel reviewed published evidence on BoNT-A immunoresistance in aesthetic and therapeutic applications and discussed best practices integrating clinical, ethical, and aesthetic considerations. Consensus statements relating to awareness, assessment, and management of the risk of NAb-related secondary nonresponse in aesthetic practice were developed. Results: There was a consensus that, as doses used in aesthetic practice become like those in therapeutics, rates of NAb formation may be expected to increase. However, the true extent of NAb formation in aesthetics is likely underestimated due to limitations of published evidence and variability in treatment patterns of aesthetic patients. Since BoNT-A therapy is often lifelong, practitioners need to recognize immunogenicity as a potential complication that might affect future therapeutic use and strive to minimize modifiable risk factors. The selection and use of a BoNT-A product with the least immunogenic potential from the beginning may thus be advantageous, especially when treatment with high doses is planned. Conclusions: In view of current trends in BoNT-A aesthetic use, it is essential for practitioners to conduct thorough clinical assessments, inform patients of treatment risks, and develop BoNT-A treatment plans to minimize immunogenicity. This can help preserve the option of continued or future BoNT-A treatment with satisfactory outcomes.