{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T03:56:26Z","timestamp":1793073386442,"version":"4.5.0"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Revance Therapeutics, Inc. (Nashville, TN, USA)"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>The therapeutic efficacy remaining from prior treatments with botulinum toxins (BoNTs) when cervical dystonia (CD) patients prefer to be re-treated has not been well characterized. Here, we assessed the residual therapeutic efficacy of BoNT injections at the time of a patient-desired re-treatment. In pivotal trials for daxibotulinumtoxinA (DAXI) in CD, subjects could request re-treatment before returning to pre-treatment symptom levels (defined as \u226420% of peak efficacy remaining). In this post hoc analysis of the Phase 3 ASPEN-OLS trial, the median percent efficacy remaining (based on change in TWSTRS total score) was determined in subjects who requested re-injection before returning to pre-treatment symptoms. Dysphagia and muscle weakness were evaluated in patients requesting re-treatment with efficacy remaining, relative to those waiting to return to baseline. There were 264 (28.7% of 920 total treatments) patient requests for re-treatment before returning to pre-treatment status across the study. The median percent efficacy remaining at the time of requested re-injection was 45.5%, which corresponded to a median of 16.0 weeks (range 10.9\u201340.3) post-treatment. The rates of dysphagia (\u22644.9%) and muscle weakness (\u22646.8%) were low and were not significantly different in those who waited for return to pre-treatment symptom status versus subjects who requested re-injection with efficacy remaining. A significant proportion of CD patients wished to be re-treated with efficacy still remaining from prior BoNT injections as early symptoms re-emerged. With the overall clinical profile of DAXI, physicians can safely provide individualized treatment regimens based on the treatment goals or symptomatic needs of their patients.<\/jats:p>","DOI":"10.3390\/toxins17030133","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T04:55:44Z","timestamp":1741755344000},"page":"133","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Efficacy Remaining at Time of Requested Re-Treatment for Cervical Dystonia: A Potential New Treatment Paradigm with DaxibotulinumtoxinA"],"prefix":"10.3390","volume":"17","author":[{"given":"Aaron","family":"Ellenbogen","sequence":"first","affiliation":[{"name":"Quest Research Institute, 28555 Orchard Lake Road, Suite 200, Farmington Hills, MI 48334, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6369-1203","authenticated-orcid":false,"given":"Robert A.","family":"Hauser","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of South Florida, Tampa, FL 33613, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2765-7953","authenticated-orcid":false,"given":"Atul T.","family":"Patel","sequence":"additional","affiliation":[{"name":"Kansas City Bone & Joint Clinic, Overland Park, KS 66211, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"McAllister","sequence":"additional","affiliation":[{"name":"New England Institute for Neurology and Headache, Stamford, CT 06905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5482-5313","authenticated-orcid":false,"given":"Todd M.","family":"Gross","sequence":"additional","affiliation":[{"name":"Revance Therapeutics Inc., Nashville, TN 37203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashid","family":"Kazerooni","sequence":"additional","affiliation":[{"name":"Revance Therapeutics Inc., Nashville, TN 37203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5488-6594","authenticated-orcid":false,"given":"Conor J.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Revance Therapeutics Inc., Nashville, TN 37203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Hollander","sequence":"additional","affiliation":[{"name":"Revance Therapeutics Inc., Nashville, TN 37203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"ref_1","unstructured":"(2023, January 21). 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