To provide clinical insights and real-world data on the use of DaxibotulinumtoxinA (Daxxify) in patients with Cervical Dystonia (CD).

BotulinumtoxinA is the treatment of choice for CD. Recent studies on a novel formulation, Daxxify, indicate its safety, efficacy, and a prolonged duration of therapeutic effect compared to traditional BotulinumtoxinA products. This report summarizes our real-world clinical experiences with Daxxify providing evidence for its potential as optimal therapeutic alternative.

Over a 12-month period, we treated more than 30 patients diagnosed with CD using Daxxify. Our cohort consisted of both toxin-naïve and toxin-experienced individuals allowing for a broad evaluation of dosing strategies and treatment outcomes.

Patients received doses ranging between 60-570U, with toxin-experienced individuals transitioning from OnabotulinumtoxinA or IncobotulinumtoxinA using a conversion ratio ranging from 1:1 to 1:3. Optimal clinical response was noted at a 1:1.5 conversion ratio. A subset of patients exhibited an onset of symptom relief within 48 hours, thus adding more days of relief of spasm and pain. Injection-related pain was reported to be higher in some patients when compared to previous treatments. However, the use of bacteriostatic saline instead of normal saline significantly reduced pain levels in all subsequent treatments. Furthermore, Daxxify demonstrated efficacy in patients with concurrent Oromandibular Dystonia and Chronic Migraine. The only reported adverse events were shoulder weakness and dysphagia in a patient with Vascular Parkinson’s Disease who was undergoing a medication change and a viral illness at the time, so causal relationship could not be clearly established. A minority of patients exhibited reduced efficacy and reverted to previous therapies.

Daxxify is a good treatment option in patients with CD, particularly in patients unsatisfied with the outcomes of previous therapies. Further studies may be warranted to explore its broader applications in the treatment of other conditions and to optimize dosing strategies for individualized patient care.