A novel BTX-formula with minimized protein envelope complex (Xeomin) in the treatment of patients with cervical dystonia and secondary response failure

Background: Due to development of neutralizing antibodies against Botuninumtoxin (BTX) and its complex of accompanying proteins, secondary response failure occurs in 1–5% of all patients with cervical dystonia (CD) treated with BTX over a period of several years. Whereas a development of neutralizing antibodies is boostered by high dosages and short treatment intervalls, a further component contributing to high antibody titers is the presence of the accompanying 650 kDa-protein complex. A novel purified 150kDa-BTX-formula (Xeomin) which has been separated from this protein complex is available for the treatment…