Effects of repeated abobotulinumtoxinA injections in upper limb spasticity |
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| Authors: | Jean‐Michel Gracies MD PhD Michael O'Dell MD Michele Vecchio MD PhD Peter Hedera MD PhD Serdar Kocer MD Monika Rudzinska‐Bar MD PhD Bruce Rubin MD Sofiya L. Timerbaeva MD PhD Anna Lusakowska MD PhD François Constant Boyer MD PhD Anne‐Sophie Grandoulier MSc Claire Vilain MD Philippe Picaut PharmD for the International AbobotulinumtoxinA Adult Upper Limb Spasticity Study Group |
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| Affiliation: | 1. EA 7377 BIOTN, Université Paris‐Est Créteil, Service de Rééducation Neurolocomotrice, H?pitaux Universitaires Henri Mondor, Créteil, France;2. Department of Rehabilitation Medicine, Weill Cornell Medicine, Baker Pavilion, New York, New York, USA;3. Department of U.O. Physical Medicine and Rehabilitation, Policlinico Vittorio Emanuele University Hospital, Catania, Italy;4. Department of Neurology, Division of Movement Disorders, Vanderbilt University, Nashville, Tennessee, USA;5. Centre de Rééducation H?pital du Jura, Porrentruy, Switzerland;6. Department of Neurology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland;7. Design Neuroscience Center, Doral, Florida, USA;8. Research Center of Neurology, Moscow, Russia;9. Department of Neurology, Medical University of Warsaw, Poland;10. EA 3797, Unités de Médecine Physique et de Réadaptation, H?pital Universitaire Sébastopol, Champagne Ardenne, France;11. Ipsen Innovation, Les Ulis, France |
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| 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 |
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| Keywords: | active function botulinum toxin open label stroke traumatic brain injury upper limb spasticity |
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