Intrathecal Baclofen Monotherapy and Polyanalgesia for Treating Chronic Pain in Patients with Severe Spasticity

Marathe, Anuj; Allahabadi, Sameer; Abd‐Elsayed, Alaa; Saulino, Michael; Hagedorn, Jonathan M; Orhurhu, Vwaire; Karri, Jay

doi:10.1007/s11916-021-00994-9

Cited by 6 publications

(2 citation statements)

References 52 publications

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“…The efficacy of ITB for pain has not been established, and increased doses for pain relief should be used with caution. 31 , 32 )…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease

KIMOTO,

OSHINO,

TANI

et al. 2023

Neurol. Med. Chir.(Tokyo)

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Intrathecal baclofen (ITB) therapy effectively treats spasticity caused by brain or spinal cord lesions. However, only a few studies compare the course of treatment for different diseases. We investigated the change in daily dose of baclofen per year and its associated adverse events in patients presenting with the three most common etiologies at our institute: hereditary spastic paraplegia, cerebral palsy, and spinal cord injury. The ITB pumps were implanted from July 2007 to August 2019, with a mean follow-up period of 70 months. In patients with hereditary spastic paraplegia, baclofen dosage was reduced after eight years following ITB introduction, and the treatment was terminated in one patient owing to disease progression. In patients with cerebral palsy, the dosage increased gradually, and became constant in the 11th year. Patients with spinal cord injury gradually increased their baclofen dosage throughout the entire observation period. Severity and adverse event rates were higher in patients with cerebral palsy than in others. The degree and progression of spasticity varied depending on the causative disease. Understanding the characteristics and natural history of each disease is important when continuing ITB treatment.

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“…The efficacy of ITB for pain has not been established, and increased doses for pain relief should be used with caution. 31 , 32 )…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease

KIMOTO,

OSHINO,

TANI

et al. 2023

Neurol. Med. Chir.(Tokyo)

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“…Intrathecal baclofen combinations have also been proposed for the treatment of chronic pain and spasticity. In line with the PACC proposals for its use as an adjuvant, reports have been made of its combined use (144), with clonidine (122), ziconotide (145), morphine (146), and bupivacaine (147,148).…”

Section: Combination Of Analgesic Therapiesmentioning

confidence: 99%

Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient

et al. 2022

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Advances in our understanding of the biology of spinal systems in organizing and defining the content of exteroceptive information upon which higher centers define the state of the organism and its role in the regulation of somatic and automatic output, defining the motor response of the organism, along with the unique biology and spatial organization of this space, have resulted in an increased focus on therapeutics targeted at this extracranial neuraxial space. Intrathecal (IT) drug delivery systems (IDDS) are well-established as an effective therapeutic approach to patients with chronic non-malignant or malignant pain and as a tool for management of patients with severe spasticity and to deliver therapeutics that address a myriad of spinal pathologies. The risk to benefit ratio of IDD makes it a useful interventional approach. While not without risks, this approach has a significant therapeutic safety margin when employed using drugs with a validated safety profile and by skilled practioners. The present review addresses current advances in our understanding of the biology and dynamics of the intrathecal space, therapeutic platforms, novel therapeutics, delivery technology, issues of safety and rational implementation of its therapy, with a particular emphasis upon the management of pain.

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A Review of Chronic Pain and Device Interventions: Benefits and Future Directions

Stark

Isaamullah

Hassan³

et al. 2022

Pain Ther

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Intrathecal Baclofen Monotherapy and Polyanalgesia for Treating Chronic Pain in Patients with Severe Spasticity

Cited by 6 publications

References 52 publications

Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease

Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease

Intrathecal Drug Delivery: Advances and Applications in the Management of Chronic Pain Patient

A Review of Chronic Pain and Device Interventions: Benefits and Future Directions

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