David Simpson from Mount Sinai Hospital: New Guidelines Provide Clearer Picture for Botulinum Toxin Use

As with many parts of medicine guidelines are constantly being updated across a variety of specialties. The American Academy of Neurology recently released new guidance on how and when to use botulinum toxin in patient care.

David M. Simpson, MD, of Mount Sinai Hospital, explained how new guidelines provide a clearer picture for botulinum toxin use during the American Academy of Neurology's (AAN) annual meeting in Vancouver.

One of the major developments in the new guidelines was the use of the toxin in treatment of neurological diseases. The previous guidelines revolved around articles published in 2008, which focused on a wide range of botulinum’s use. But since then, new literature provided updates to data, isolating the performance of each formulation of the toxin instead of combining them.

Simpson said the updated information showed botulinum in use to treat chronic migraine headache, spasticity in adults, cervical dystonia and blepharospasm. He added that using the terms Botox and botulinum toxin interchangeably is not necessarily correct, as Botox is one of several brand names of the toxin. Four brands of botulinum toxin are approved for use in the United States, for example. Each of the formulated brands do not have the same use, he said.

“Both in terms of the data supporting the use of these botulinum toxins of neurological diseases, and in the clinical trials, they are done with one toxin at a time. So one needs to look at the data for that particular formulation, to determine the efficacy and safety,” Simpson said.

As doctors look to the toxin as a potential treatment method Simpson noted that the US Food and Drug Administration labels are now clear in each drug’s use.

The new guidelines, Simpson said, itemize each drug, and how they respectively performed in the treatment of each neurological disease.