Botulinum Neurotoxins for Relief of Pain Associated with Spasticity

Jabbari, Bahman

doi:10.1007/978-1-4939-2501-8_11

Cited by 3 publications

(4 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a prospective, observational study of 282 children with CP, BoNT-A (formulation not specified) significantly reduced pain at rest and during mobilization, lasting up to 12 months post-injection, in a subset of 46 children (16%) with pain at baseline [ 38 ]. Jabbari [ 39 ] provided anecdotal evidence from clinical experience with more than 200 children with CP (some of whom were followed for up to 8 years), noting that pain was reduced in children with CP after BoNT-A injections (further details not provided). In a small, prospective, double-blind study of 41 non-ambulatory children with SRP, onabotulinumtoxinA reduced pain compared to baseline at 4 and 16 weeks in 18 children who reported pain on the Pediatric Pain Profile at baseline.…”

Section: Discussionmentioning

confidence: 99%

Spasticity-related pain in children/adolescents with cerebral palsy. Part 2: IncobotulinumtoxinA efficacy results from a pooled analysis

Bonfert

Heinen

Kaňovský

et al. 2023

PRM

View full text Add to dashboard Cite

PURPOSE: This pooled analysis of data from three Phase 3 studies investigated the effects of incobotulinumtoxinA on spasticity-related pain (SRP) in children/adolescents with uni-/bilateral cerebral palsy (CP). METHODS: Children/adolescents (ambulant and non-ambulant) were evaluated for SRP on increasingly difficult activities/tasks 4 weeks after each of four incobotulinumtoxinA injection cycles (ICs) using the Questionnaire on Pain caused by Spasticity (QPS; six modules specific to lower limb [LL] or upper limb [UL] spasticity and respondent type [child/adolescent, interviewer, or parent/caregiver]). IncobotulinumtoxinA doses were personalized, with all doses pooled for analysis. RESULTS: QPS key item responses were available from 331 and 155 children/adolescents with LL- and UL-spasticity, respectively, and 841/444 (LL/UL) of their parents/caregivers. IncobotulinumtoxinA efficacy was evident with the first IC. Efficacy was sustained and became more robust with further subsequent ICs. By week 4 of the last (i.e. fourth) IC, 33.8–53.3% of children/adolescents reported complete SRP relief from their baseline pain for respective QPS items. Children/adolescents reported reductions in mean LL SRP intensity at levels that surpassed clinically meaningful thresholds. Similarly, parents/caregivers observed complete SRP relief and less frequent SRP with incobotulinumtoxinA. Similar results were found for UL SRP. CONCLUSION: These findings indicate that incobotulinumtoxinA could bring considerable benefit to children/adolescents with spasticity by reducing SRP, even during strenuous activities.

show abstract

Section: Discussionmentioning

confidence: 99%

Spasticity-related pain in children/adolescents with cerebral palsy. Part 2: IncobotulinumtoxinA efficacy results from a pooled analysis

Bonfert

Heinen

Kaňovský

et al. 2023

PRM

View full text Add to dashboard Cite

show abstract

“…Studies on other populations with spasticity have shown promising results for botulinum toxin A as a treatment for spasticity-related pain. This has been described thoroughly by B. Jabbari et al (2015), who examined several studies [ 38 ]. Five out of nine studies on upper limb spasticity showed positive results, and in four of the studies, the pain-relieving effect was shown in approximately 90% of the patients.…”

Section: Existing Literature On the Analgesic Effect Of Botulinum mentioning

confidence: 99%

“…Other RCT studies investigating pain have shown the same conflicting results, where patients respond positively to both the placebo and the treatment with botulinum toxin [ 38 ]. This may reflect a high placebo effect, which plausibly could be interrelated to the use of only one, highly subjective pain tool.…”

Section: Existing Literature On the Analgesic Effect Of Botulinum mentioning

confidence: 99%

Analgesic Effects of Botulinum Toxin in Children with CP

Michelsen

Normann

Wong

2018

Toxins

View full text Add to dashboard Cite

Experiencing pain is the greatest contributor to a reduced quality of life in children with cerebral palsy (CP). The presence of pain is quite common (~60%) and increases with age. This leads to missed school days, less participation, and reduced ambulation. Despite these alarming consequences, strategies to relieve the pain are absent and poorly studied. Moreover, it is difficult to evaluate pain in this group of children, especially in cases of children with cognitive deficits, and tools for pain evaluation are often inadequate. Botulinum toxin has been shown to alleviate pain in a variety of disorders and could potentially have an analgesic effect in children with CP as well. Even though most of the studies presented here show promising results, many also have limitations in their methodology as it is unlikely to capture all dimensions of pain in this heterogeneous group using only one assessment tool. In this review, we present a new way of examining the analgesic effect of botulinum toxin in children with CP using a variety of pain scores.

show abstract

“…In addition to negatively affecting health-related quality of life (QoL) [ 4 ], pain often interferes with the already limited physical function, performance, and presentism in school, daily care activities, participation, sleep, and mental health [ 1, 5, 6 ] in those with CP. Spasticity-related pain (SRP) can be continuous or recurrent [ 7 ] and some patients report that SRP can be more disabling than the spasticity itself [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Spasticity-related pain in children/adolescents with cerebral palsy. Part 1: Prevalence and clinical characteristics from a pooled analysis

Heinen

Bonfert

Kaňovský

et al. 2022

PRM

View full text Add to dashboard Cite

PURPOSE: A large prospective database from three Phase 3 studies allowed the study of spasticity-related pain (SRP) in pediatric cerebral palsy (CP). METHODS: Baseline (pretreatment) SRP data occurring during different activities in children/adolescents (aged 2–17 years, ambulant/nonambulant) with uni-/bilateral spastic CP was obtained using the Questionnaire on Pain caused by Spasticity (QPS; six modules specific to spasticity level [lower limb (LL) or upper limb (UL)] and type of respondent [child/adolescent, interviewer, or parent/caregiver]). RESULTS: At baseline, 331 children/adolescents with LL- and 155 with UL-spasticity completed at least one key item of their modules; LL/UL QPS modules of parent/caregivers were at least partially completed (key items) by 841/444 parents/caregivers. SRP with at least one activity at baseline was self-reported in 81.9% /69.7% (LLs/ULs) of children/adolescents with spasticity. Parents/caregivers observed LL/UL SRP behaviors in 85.9% /77.7% of their children, with multiple body regions affected. SRP negatively affected the great majority of the children in various ways. Child/adolescent-reported mean SRP intensity and parent/caregiver-observed mean SRP behavior frequencies were higher for LLs than ULs, and the level of SRP increased with more physically demanding activities. CONCLUSION: These data suggest SRP is more common and intense in pediatric CP than generally thought, emphasizing the need for effective, long-term pain management.

show abstract

Botulinum Neurotoxins for Relief of Pain Associated with Spasticity

Cited by 3 publications

References 33 publications

Spasticity-related pain in children/adolescents with cerebral palsy. Part 2: IncobotulinumtoxinA efficacy results from a pooled analysis

Spasticity-related pain in children/adolescents with cerebral palsy. Part 2: IncobotulinumtoxinA efficacy results from a pooled analysis

Analgesic Effects of Botulinum Toxin in Children with CP

Spasticity-related pain in children/adolescents with cerebral palsy. Part 1: Prevalence and clinical characteristics from a pooled analysis

Contact Info

Product

Resources

About