Most MS patients satisfied with botulinum toxin for spasticity
Study examines use of treatment to help manage spasms from muscle tightness
People with multiple sclerosis (MS) who are treated with formulations of botulinum toxin to manage spasticity generally report being satisfied with the treatment, a new study reports.
The study examined the use of these formulations in people with spasticity due to a number of conditions, the most common being stroke and MS. Its findings support the effectiveness of botulinum toxin injections in treating spasticity regardless of its underlying cause, researchers wrote.
The study, “Spasticity Management with Botulinum Toxin in Post-stroke and Multiple Sclerosis Patients: A Retrospective, ‘Real-world’, Multicenter Study,” was published in NeuroRehabilitation.Â
Drugs’ effectiveness in treating spasticity in variety of conditions studied
Spasticity, or muscle tightness, is a common symptom of MS. Spasticity in MS develops because nerves are sending abnormal signals to muscle cells telling the muscles to contract, causing muscles to become overly tight. This is often accompanied by muscle spasms, or sudden, involuntary muscle movements.
Botulinum toxin is a neurotoxin made by certain bacteria that works by blocking the release of acetylcholine, a neurotransmitter that signals muscle contraction, leading to paralysis.
Several medications use carefully dosed amounts of botulinum toxin injected into muscles to ease spasticity. Formulations of botulinum toxin that are approved to ease spasticity in the U.S. include Botox (onabotulinumtoxinA), Dysport (abobotulinumtoxinA), and Xeomin (incobotulinumtoxinA).
While strong evidence of their effectiveness is available for people with stroke, less is known about how effective these drugs are in treating spasticity due to different conditions, mostly due to a lack of controlled trials.
To learn more, a team led by scientists in Italy reported on outcomes from a total of 152 people who received botulinum toxin treatment to ease spasticity due to a variety of conditions, including stroke, MS, traumatic brain injury, a congenital disorder, a tumor, and inflammation or infection.
The work was funded by Ipsen, which markets Dysport.
Most MS patients had lower limb spasticity
Among the total 152 participants, 47 had MS. These patients mostly had lower limb spasticity and waited the longest time from the onset of their spasticity to receiving botulinum toxin treatment (13.6 years vs. 2.2 years for those with stroke). The median duration of treatment was 41.9 months (about 3.5 years), and 52% were still receiving treatment at the time of the analysis.
Results indicated most patients, regardless of their underlying disease, were overall satisfied with botulinum toxin treatment.
The majority of patients were overall satisfied with repeated treatment over several cycles and the data support the effectiveness of [botulinum toxin] injections in focal spasticity management regardless of etiology [underlying cause].
Among the MS patients, more than half (58.7%) reported being either satisfied or very satisfied after their first cycle of treatment. After the last cycle, nearly two-thirds (63.7%) of the MS patients reported being either satisfied or very satisfied with the treatment. Similar satisfaction was reported among patients who had experienced stroke or other disorders.
“The majority of patients were overall satisfied with repeated treatment over several cycles and the data support the effectiveness of [botulinum toxin] injections in focal spasticity management regardless of etiology [underlying cause],” the researchers wrote.
The researchers also noted that most of the patients ended up switching between different formulations of botulinum toxin, mostly due to changes in availability at pharmacies, but satisfaction seemed to be largely comparable with the different therapies.
Botulinum toxin treatment was overall tolerated well by the patients in this study, and no serious safety issues were documented.
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