The Use of Botulinum Toxin in Medicine: Safety and Efficacy Based on the Latest Research
DOI:
https://doi.org/10.12775/JEHS.2023.44.01.003Keywords
botulinum, botulinum toxin, botulinum treatment, botulinum aestheticAbstract
Introduction and aim of the study: Botulinum toxin, produced by anaerobic bacteria of the Clostridium botulinum family, is one of the most potent organic compounds known to man. Despite its toxicity, it has found widespread use in medicine. From applications in aesthetic medicine, through the treatment of various disease entities, botulinum toxin has become an extremely valuable tool in the hands of doctors. The aim of this study is to review the latest research on the use of botulinum in medicine, with an emphasis on its safety and effectiveness.
Methodology: The review work is mainly based on articles searched in the Pubmed and Google Scholar databases in the years 2016-2023. The study was conducted by reviewing keywords such as "botulin", "botulin toxin", "botulin treatment", "botulin aesthetic".
Current state of knowledge: Botulinum is used in the treatment of such disease entities as hyperhidrosis, cervical dystonia, migraines, neurogenic bladder, as well as in the treatment of scars and wrinkles. The use of botulinum in medicine is safe, provided that it is used by qualified specialists and in appropriate doses. An area that requires further research is the impact of long-term botulinum therapy on the antibodies produced against the toxin. Additionally, an important area for further research is patient monitoring, appropriate dose adjustment and frequency of administration, which in turn can increase the effectiveness of treatment.
Summary: Botulinum toxin is an effective tool in medicine, which has many applications. However, as with any drug, it requires appropriate use and understanding of potential side effects. Further research and education are key to fully exploiting its potential and assessing the risk associated with long-term use.
References
International Society of Aesthetic Plastic Surgery. (2022). Międzynarodowe badanie dotyczące procedur estetycznych/kosmetycznych. Pobrano 17 lipca 2023, z https://www.isaps.org/media/vdpdanke/isaps-global-survey_2021.pdf
Shukla HD, Sharma SK. Clostridium botulinum: a bug with beauty and weapon. Critical Reviews in Microbiology. 2005;31(1):11-8. DOI: 10.1080/10408410590912952. English.
World Health Organization. (2018). Botulizm. Dostępne na: https://www.who.int/news-room/fact-sheets/detail/botulism (dostęp: 17.07.2023)
Figgitt DP, Noble S. Botulinum Toxin B: A Review of its Therapeutic Potential in the Management of Cervical Dystonia. Adis Drug Evaluation. 2002;62:705–722. English.
Sobel J. Botulism. Clinical Infectious Diseases. 2005;41(8):1167–1173. DOI: 10.1086/444507. English.
Łyżwa, M. (2023). The mechanism of action of botulinum neurotoxin type A and post-treatment recommendations - taming the myths. Akademia Medycyny Estetycznej i Anti-Aging Medicine, 2/2023, 2-4.
Hermjakob, H., Montecchi-Palazzi, L., Bader, G., Wojcik, J., Salwinski, L., Ceol, A., Moore, S., Orchard, S., Sarkans, U., von Mering, C., Roechert, B., Poux, S., Jung, E., Mersch, H., Kersey, P., Lappe, M., Li, Y., Zeng, R., Rana, D., Nikolski, M., Husi, H., Brun, C., Shanker, K., Grant, S.G.N., Sander, C., Bork, P., Zhu, W., Pandey, A., Brazma, A., Jacq, B., Vidal, M., Sherman, D., Legrain, P., Cesareni, G., Xenarios, I., Eisenberg, D., Steipe, B., Hogue, C., & Apweiler, R. (2004). The HUPO PSI's molecular interaction format--a community standard for the representation of protein interaction data. Nature Biotechnology, 22(2), 177-83. DOI: 10.1038/nbt926.
Simpson, D.M., Hallett, M., Ashman, E.J., Comella, C.L., Green, M.W., Gronseth, G.S., Armstrong, M.J., Gloss, D., Potrebic, S., Jankovic, J., Karp, B.P., Naumann, M., So, Y.T., & Yablon, S.A. (2016). Practice guideline update summary: Botulinum neurotoxin for the treatment of blepharospasm, cervical dystonia, adult spasticity, and headache: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 86(19), 1818-26. DOI: 10.1212/WNL.0000000000002560.
Li, B., Peet, N.P., Butler, M.M., Burnett, J.C., Moir, D.T., & Bowlin, T.L. (2011). Small Molecule Inhibitors as Countermeasures for Botulinum Neurotoxin Intoxication. Molecules, 16(1), 202-220. DOI: 10.3390/molecules16010202.
Montecucco, C., & Molgó, J. (2005). Botulinal neurotoxins: revival of an old killer. Current Opinion in Pharmacology, 5(3), 274-9. DOI: 10.1016/j.coph.2004.12.006.
Nigam, PK (2010). „TOKSYNA BOTULINOWA” . Indian Journal of Dermatology . 55 (1): 8–14. doi : 10.4103/0019-5154.60343 . PMC 2856357 . PMID 20418969 .
Ni, S. A., & Brady, M. F. (2023). Botulism Antitoxin. W: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Aktualizacja 5 września 2022. Dostępne w: [link do źródła]. PMID: 30521228. Bookshelf ID: NBK534807.
Mierzejewski, J. (1989). Budowa, działanie i zastosowanie kliniczne toksyny botulinowej. Życie Weterynaryjne, 64(06), 166-170.
Zbrojkiewicz, M., Lebiedowska, A., & Błońska-Fajfrowska, B. (2018). Botulinum toxin in medicine and cosmetology – two hundred years’ history and new perspectives. Postępy Higieny i Medycyny Doświadczalnej (online), 72, 278-289. e-ISSN 1732-2693.
Li, X., Sui, C., Xia, X., & Chen, X. (2023). Efficacy and Safety of Botulinum Toxin Type A for Treatment of Glabellar Lines: A Network Meta-Analysis of Randomized Controlled Trials. Aesthetic Plastic Surgery, 47(1), 365-377. DOI: 10.1007/s00266-022-03018-y.
Hilton, S., Kestemont, P., Sattler, G., Volteau, M., Thompson, C., Andriopoulos, B., Prygova, I., Berg, A-K., & Ascher, B. (2022). Liquid AbobotulinumtoxinA: Pooled Data From Two Double-Blind, Randomized, Placebo-Controlled Phase III Studies of Glabellar Line Treatment. Dermatologic Surgery, 48(11), 1198-1202. DOI: 10.1097/DSS.0000000000003594.
Camargo, C.P., Xia, J., Costa, C.S., Gemperli, R., Tatini, M.D., Bulsara, M.K., & Riera, R. (2021). Botulinum toxin type A for facial wrinkles. The Cochrane Database of Systematic Reviews, 7(7), CD011301. DOI: 10.1002/14651858.CD011301.pub2.
Cohen, J.L., Fagien, S., Ogilvie, P., De Boulle, K., Carruthers, J., Cox, S.E., Kelly, R., Garcia, J.K., & Sangha, S. (2022). High Patient Satisfaction for up to 6 Months With OnabotulinumtoxinA Treatment for Upper Facial Lines. Dermatologic Surgery, 48(11), 1191-1197. DOI: 10.1097/DSS.0000000000003585.
Rahman, E., Mosahebi, A., Carruthers, J.D., & Carruthers, A. (2023.). The Efficacy and Duration of Onabotulinum Toxin A in Improving Upper Facial Expression Lines With 64-Unit Dose Optimization: A Systematic Review and Meta-Analysis With Trial Sequential Analysis of the Randomized Controlled Trials. Aesthetic Surgery Journal. DOI: 10.1093/asj/sjac253.
Carr, W.W., Jain, N., & Sublett, J.W. (2021). Immunogenicity of Botulinum Toxin Formulations: Potential Therapeutic Implications. Advances in Therapy, 38(10), 5046-5064. DOI: 10.1007/s12325-021-01882-9.
Frevert, J. (2015). Pharmaceutical, Biological, and Clinical Properties of Botulinum Neurotoxin Type A Products. Drugs in R&D, 15(1), 1-9. DOI: 10.1007/s40268-014-0077-1.
Sun, P., Lu, X., Zhang, H., & Hu, Z. (2021). The Efficacy of Drug Injection in the Treatment of Pathological Scar: A Network Meta-analysis. Aesthetic Plastic Surgery, 45(2), 791-805. DOI: 10.1007/s00266-019-01570-8.
Chen, S., Yang, Y., Zhang, D., Liu, Y., & Li, Y. (2020). Local Injection of Botulinum Toxin Type A to Prevent Postoperative Scar. The Journal of Craniofacial Surgery, 31(2), 440-443. DOI: 10.1097/SCS.0000000000006144.
Wang, Y., Wang, J., Zhang, J., Hu, C., & Zhu, F. (2019). Effectiveness and Safety of Botulinum Toxin Type A Injection for Scar Prevention: A Systematic Review and Meta-analysis. Aesthetic Plastic Surgery, 43(5), 1241-1249. DOI: 10.1007/s00266-019-01358-w.
Obed, D., Salim, M., Bingoel, A.S., Hofmann, T.R., Vogt, P.M., & Krezdorn, N. (2021). Botulinum Toxin Versus Placebo: A Meta-Analysis of Treatment and Quality-of-life Outcomes for Hyperhidrosis. Aesthetic Plastic Surgery, 45(4), 1783-1791. DOI: 10.1007/s00266-021-02140-7.
Galadari, H., Galadari, I., Smit, R., Prygova, I., & Redaelli, A. (2021). Treatment approaches and outcomes associated with the use of abobotulinumtoxinA for the treatment of hyperhidrosis: A systematic review. Journal of the American Academy of Dermatology, 85(5), 1121-1129. DOI: 10.1016/j.jaad.2020.07.123.
Nicholas, R., Quddus, A., & Baker, D.M. (2015). Treatment of Primary Craniofacial Hyperhidrosis: A Systematic Review. American Journal of Clinical Dermatology, 16(5), 361-70. DOI: 10.1007/s40257-015-0136-6.
Nasr, M.W., Jabbour, S.F., Haber, R.N., Kechichian, E.G., & Hachem, L.E. (2017). Comparison of microwave ablation, botulinum toxin injection, and liposuction-curettage in the treatment of axillary hyperhidrosis: A systematic review. Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology, 19(1), 36-42. DOI: 10.1080/14764172.2016.1248438.
Li, C., Wu, F., Zhang, Q., Gao, Q., Shi, Z., & Li, L. (2015). Interventions for the treatment of Frey's syndrome. The Cochrane Database of Systematic Reviews, (3):CD009959. DOI: 10.1002/14651858.CD009959.pub2.
Chudry, H. (2022). The treatment of palmar hyperhidrosis - a systematic review. International Journal of Dermatology, 61(11), 1303-1310. DOI: 10.1111/ijd.15937.
Boczarska-Jedynak, M., & Sławek, J. (2023). Praktyczne aspekty leczenia migreny przewlekłej toksyną botulinową typu A. Farmakoterapia Chorób Układu Nerwowego. Pobrano z https://journals.viamedica.pl/polski_przeglad_neurologiczny/article/download/55244/41550 na dzień 17,07.2023.
Affatato, O., Moulin, T.C., Pisanu, C., Babasieva, V.S., Russo, M., Aydinlar, E.I., Torelli, P., Chubarev, V.N., Tarasov, V.V., Schiöth, H.B., & Mwinyi, J. (2021). High efficacy of onabotulinumtoxinA treatment in patients with comorbid migraine and depression: a meta-analysis. Journal of Translational Medicine, 19(1):133. DOI: 10.1186/s12967-021-02801-w.
Lanteri-Minet, M., Ducros, A., Francois, C., Olewinska, E., Nikodem, M., & Dupont-Benjamin, L. (2022). Effectiveness of onabotulinumtoxinA (BOTOX®) for the preventive treatment of chronic migraine: A meta-analysis on 10 years of real-world data. Cephalalgia: An International Journal of Headache, 42(14), 1543-1564. DOI: 10.1177/03331024221123058.
Zheng, H., Huang, S.L., Chen, Y.Y., Tang, T.C., Qin, D., & Chen, M. (2021). Topiramate, acupuncture, and BoNT-A for chronic migraine: a network meta-analysis. Acta Neurologica Scandinavica, 143(5), 558-568. DOI: 10.1111/ane.13391.
Bruloy, E., Sinna, R., Grolleau, J. L., Bout-Roumazeilles, A., Berard, E., & Chaput, B. (2019). Botulinum Toxin versus Placebo: A Meta-Analysis of Prophylactic Treatment for Migraine. Plastic and Reconstructive Surgery, 143(1), 239-250. DOI: 10.1097/PRS.0000000000005111.
Albanese, A., Wissel, J., Jost, W. H., Castagna, A., Althaus, M., Comes, G., Scheschonka, A., Vacchelli, M., & Jinnah, H. A. (2023). Pain Reduction in Cervical Dystonia Following Treatment with IncobotulinumtoxinA: A Pooled Analysis. Toxins (Basel), 15(5), 333. DOI: 10.3390/toxins15050333.
Fasano, A., Paramanandam, V., & Jog, M. (2020). Use of AbobotulinumtoxinA in Adults with Cervical Dystonia: A Systematic Literature Review. Toxins (Basel), 12(8), 470. DOI: 10.3390/toxins12080470.
Mittal, S. O., Machado, D., Richardson, D., Dubey, D., & Jabbari, B. (2018). Botulinum toxin in essential hand tremor - A randomized double-blind placebo-controlled study with customized injection approach. Parkinsonism & Related Disorders, 56, 65-69. DOI: 10.1016/j.parkreldis.2018.06.019.
Liao, Y. H., Hong, C. T., & Huang, T. W. (2022). Botulinum Toxin for Essential Tremor and Hands Tremor in the Neurological Diseases: A Meta-Analysis of Randomized Controlled Trials. Toxins (Basel), 14(3), 203. DOI: 10.3390/toxins14030203.
Bapir, R., Bhatti, K. H., Eliwa, A., García-Perdomo, H. A., Gherabi, N., Hennessey, D., Magri, V., Mourmouris, P., Ouattara, A., Perletti, G., Philipraj, J., Stamatiou, K., Trinchieri, A., & Buchholz, N. (2022). Efficacy of overactive neurogenic bladder treatment: A systematic review of randomized controlled trials. Archivio Italiano di Urologia e Andrologia, 94(4), 492-506. DOI: 10.4081/aiua.2022.4.492.
Martina, E., Diotallevi, F., Radi, G., Campanati, A., & Offidani, A. (2021). Therapeutic Use of Botulinum Neurotoxins in Dermatology: Systematic Review. Toxins (Basel), 13(2), 120. DOI: 10.3390/toxins13020120.
Nigam, P. K., & Nigam, A. (2010). Botulinum toxin. Indian Journal of Dermatology, 55(1), 8-14. DOI: 10.4103/0019-5154.60343.
Witmanowski, H., & Błochowiak, K. (2020). The whole truth about botulinum toxin - a review. Postepy Dermatologii i Alergologii, 37(6), 853-861. DOI: 10.5114/ada.2019.82795.
Zargaran, D., Zoller, F., Zargaran, A., Rahman, E., Woollard, A., Weyrich, T., & Mosahebi, A. (2022). Complications of Cosmetic Botulinum Toxin A Injections to the Upper Face: A Systematic Review and Meta-Analysis. Aesthetic Surgery Journal, 42(5), NP327–NP336. https://doi.org/10.1093/asj/sjac036
Coté, T. R., Mohan, A. K., Polder, J. A., Walton, M. K., & Braun, M. M. (2005). Botulinum toxin type A injections: adverse events reported to the US Food and Drug Administration in therapeutic and cosmetic cases. Journal of the American Academy of Dermatology, 53(3), 407-415. DOI: 10.1016/j.jaad.2005.06.011
Charles, D., Brashear, A., Hauser, R. A., Li, H. I., Boo, L. M., & Brin, M. F. (2012). Efficacy, tolerability, and immunogenicity of onabotulinumtoxina in a randomized, double-blind, placebo-controlled trial for cervical dystonia. Clinical Neuropharmacology, 35(5), 208-214. DOI: 10.1097/WNF.0b013e31826538c7
Rahman, E., Alhitmi, H. K., & Mosahebi, A. (2022). Immunogenicity to Botulinum Toxin Type A: A Systematic Review With Meta-Analysis Across Therapeutic Indications. Aesthetic Surgery Journal, 42(1), 106-120. DOI: 10.1093/asj/sjab058
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Copyright (c) 2023 Anna Jaremek, Joanna Kępa, Norbert Kandefer, Michał Wyszkowski, Aleksandra Grabarczyk, Anna Pawlak, Sylwia Grad, Małgorzata Gregorek, Paweł Gregorek
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