Effects of repeated abobotulinumtoxinA injections in upper limb spasticity

Abstract

Introduction: The efficacy of single injections of abobotulinumtoxinA (Dysport) is established in adults with upper limb spasticity. In this study we assessed the effects of repeated injections of abobotulinumtoxinA over 1 year. Methods: Patients (n = 258, safety population) received 500 U, 1,000 U, or 1,500 U (1,500‐U dose included 500‐U shoulder injections) for up to 4 or 5 treatment cycles. Assessments included treatment‐emergent adverse events (TEAEs), muscle tone, passive and active range of motion (XV1, XA), angle of catch (XV3), Disability Assessment Scale (DAS) score, Modified Frenchay Scale (MFS) score, and Physician Global Assessment (PGA) score. Results: The incidence of TEAEs decreased across cycles. Muscle tone reduction and XV1 remained stable across cycles, whereas XV3 and XA continued to improve at the finger, wrist, and elbow flexors. DAS and PGA improved across cycles. MFS improved best with 1,500 U. Discussion: A favorable safety profile and continuous improvements in active movements and perceived and active function were associated with repeated abobotulinumtoxinA injections in upper limb muscles. Muscle Nerve 57: 245–254, 2018

Effect on Passive Range of Motion and Functional Correlates After a Long‐Term Lower Limb Self‐Stretch Program in Patients With Chronic Spastic Paresis

“…Botulinum toxin injections were allowed in this study, and repeated injections may have eased self‐stretch techniques for injected muscles. However, botulinum toxin injections have not been demonstrated in previous studies to produce by themselves the magnitude of muscle extensibility increase nor, of ambulation speed improvement, identified here [25‐28]. Regardless, the proportions of muscles injected with botulinum toxin were similar in both muscle groups.…”

“…Exclusion criteria were (1) recurrent strokes or other events affecting involvement in rehabilitation; (2) severe cognitive impairment (Mini‐Mental State Examination score <23 or major aphasia) interfering with the ability to participate in the GSC; and (3) treatment by systemic “antispastic” agents, whether oral or intrathecal (baclofen, benzodiazepines, etc) [23,24]. In view of the absence of significant impact of botulinum toxin on muscle length, however, subjects were included regardless of the administration of botulinum toxin (or alcohol/phenol) in any muscles during the follow‐up period [25‐28].…”

Investigation of mixed model repeated measures analyses and non‐linear random coefficient models in the context of long‐term efficacy data

“…The analyses presented in this publication include combined data from 2 clinical studies, referred to as the initial study and the extension study …”

“…The statistical investigations presented in this paper were initiated to address the clinical need to better understand the behavior of a selection of efficacy parameters after repeated treatment cycles of study drug in adult subjects with spastic hemiparesis due to stroke or traumatic brain injury. 1,2 The study drug was abobotulinumtoxinA (Dysport®), delivered by intramuscular injections, and was used in these studies for the treatment of upper limb spasticity. AbobotulinumtoxinA is a Type A botulinum toxin used to treat a variety of medical conditions, including spasticity.…”

Repurposing of FDA‐Approved Drugs for Treating Iatrogenic Botulism: A Paired 3D‐QSAR/Docking Approach†

“…Botulinum neurotoxin (BoNT) is one of the most potent toxins known and is used for various clinical conditions characterized by muscular hyperactivity. Among these conditions, it is widely used in rehabilitative programs for the treatment of post‐stroke spasticity, and focal dystonia . Also, other pathologies can be treated with this drug, such as hyperhidrosis, chronic migraine, and neurological detrusor overactivity.…”