Well-Being and Quality of Life with Botulinum Toxins – Sponsored Content

There are still many unclear concepts about what botulinum toxins are and what the true scope of their uses is beyond aesthetics. For this reason, the virtual forum “The therapeutic benefits of botulinum toxins in chronic migraine, spasticity and abnormal movements”, organized by EL TIEMPO and AbbVie on Wednesday May 11, brought together several specialists who shed new light on doctors , patients and caregivers about this issue.

To start the day, Mónica Betancur, medical manager of AbbVie Colombia, began by saying that the objective of this meeting was “to realize that we have hope and that we can improve the quality of life of patients, by understanding that botulinum toxins are not only a pharmacological treatment, but they help, in a multidisciplinary way, that these people have a better quality of life on a daily basis”.

In this way they entered into participation, with the moderation of the journalist Ximena Bedoya, Dr. Paula Cavanzo, neurologist; Dr Andrés Zuluaga, pharmacologist and toxicologist, and Dr Diego Chaustre, physiatrist.

The first thing Dr. Zuluaga pointed out is that behind botulinum toxins there is a long history that goes beyond aesthetics.

“The subject began with research in 1860 that identified toxins that produced a disease called botulism. From this moment, a series of new investigations focused on the treatment of this disease and the isolation of the toxin were generated. But it was not until 1946 that it was finally possible to isolate the crystalline structure of what is now called botulinum toxin and of which different types were discovered,” reports the pharmacologist and toxicologist.

After these advances, the therapeutic implementation of toxins could be promoted and, in 1989, their use in humans to treat strabismus was approved. Since then, they have been used in various ailments.

“This clearly shows that the medical application of botulinum toxins long predates aesthetic use, even though it is the best known,” said Dr. Andrés Zuluaga.

There are different types of botulinum toxins and some of these neurotoxins have been isolated, such as type A and type B, which are currently in commerce. Some laboratories have even developed drugs based on type A neurotoxins, used to treat many ailments.

“Botulinum toxin is a biological drug”, explained the specialist. When we refer to this, we mean a component that has a living origin. It is important to mention that due to this characteristic, botulinum toxins are one of the greatest drugs available on the planet and require very complex manufacturing processes. When a manufacturer manufactures one of these drugs, its particular process defines the type of product, equally effective in its action, but particular in its development and its effects”.

Therefore, the use of botulinum toxin is very wide in terms of treating diseases, with enormous potential that has enabled medical specialists to help improve the quality of life of thousands of patients. Even in case of abnormal movements or postures caused by various discomforts.

Chronic migraine and botulinum toxins

Headaches can be a difficult condition for many people to manage, especially when it comes to migraines, a condition of which there are two main types, episodic and chronic, which are defined by how often you they arise.

Dr. Paula Cavanzo explains that chronic migraine is a disease that is mainly characterized by the fact that it presents itself constantly for more than 15 days per month. “Some patients may even suffer from headaches every day for several years. Studies indicate that adequate diagnostic processes can occur after up to 20 years of suffering,” the neurologist said.

Its impact is such that this type of migraine has become the third most common disease in the world and the second most debilitating after cardiovascular diseases, which translates into a total impact on the professional, personal and affective lives of patients.

“In the case of chronic migraine, treatment with botulinum toxin is an option for people who have already undergone other types of treatment, without significant improvement. The current indication given by national and international regulatory bodies such as the FDA and Invima is that botulinum toxin has a prophylactic use for this type of headache, the one approved in our country being onabotulinum toxin type A, or botox,” Dr. Cavanzo said.

Botulinum toxin is used in people suffering from chronic migraine for, among other benefits, spacing out the days of pain by reducing the inflammatory processes typical of the disease and maintaining this relief over time.

It has been shown that with the toxin, patients reduce the number of days of pain and its intensity, and there is an improvement in morbidities such as depression and anxiety.

However, the neurologist warned that the application of the toxin must be carried out by a specialist.

“There are several reasons: headache specialists are neurologists because we know the disease. In addition, it is a biological drug that requires special application. Also, there must be a preliminary assessment which makes it possible to determine the particular factors of the patient and thus to consider the most appropriate treatment”, specifies Dr. Cavanzo.

The main objective is therefore to reduce disability and improve the quality of life of patients.

Use of botulinum toxins and spasticity

Dr. Diego Chaustre showed that spasticity is a disorder that occurs after damage to the central nervous system, brain or spinal cord. “In our country, it is associated with five causes: stroke or stroke, multiple sclerosis, cerebral palsy, spinal cord injury and head trauma,” he added.

Spasticity has several peculiarities, which lead to increased muscle tone and joint stiffness, which generates abnormal postures and, therefore, a lot of pain. Similarly, it is variable over time in the same patient and depends on internal and external factors, such as the weather.

In case of spasticity, botulinum toxin must be integrated into a patient treatment process.

“It’s not the only intervention that should be done, but it needs to be integrated into a program that includes physiotherapy, occupational therapy and language, psychiatry, physiatry and neurology. Due to its characteristics, the use of botulinum toxins is a good option in the process. The important thing is that the specialist can identify that the patient fulfills all the conditions for this biological drug to be applied to him”, specifies Dr Chaustre.

In such cases, the impact on the patient’s quality of life is direct, whether it is allowing them to reduce spasticity and recover basic movements, such as picking up a spoon or turning the light on and off, or manage their secondary pain. In addition, it makes it possible to achieve a large number of objectives set with the patient, with measurable results.

“In addition to this, and in the case of seriously injured patients, the application of botulinum toxins makes it possible to reduce the load on their carer”, specifies the physiatrist.

There are several different brands of botulinum toxin on the market that can be used in spasticity, some approved by Invima, but each with a specific profile, as Dr. Zuluaga explains, and can be used according to individual patient conditions. .

In all cases, whether it is abnormal movements, chronic migraine, for safety and clarity, the patient must be shown the brand of toxin that is going to be applied and what is the process to follow. The medical working group also needs to know what brand was applied and where on the body.

This is critical in treatments with botulinum toxins because, when changing brands without adequate medical indication, there is a risk, in the short and medium term, that the adequate result will not be obtained by applying doses lower or higher than those indicated, with loss of the therapeutic effect of these biological drugs, seriously harming the health and well-being of patients.


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