What is the efficacy of BoNT-A in the treatment of spasticity?

Updated: Jun 28, 2019
  • Author: Krupa Pandey, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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The results of clinical trials strongly support the efficacy and safety of BoNT-A for the treatment of spasticity caused by cerebral palsy, MS, stroke, spinal cord injury, brain injury, or neurodegenerative disease. Major benefits of BoNT-A therapy for spasticity include improved function, increased ease of care and comfort, prevention or treatment of musculoskeletal complications such as contractures and pain, and cosmesis.

In a review of 18 open-label or double-blind, placebo-controlled trials by Simpson, botulinum toxin was shown to be an effective measure for reduction of focal spasticity. Improvements were documented in tone reduction, range of motion, hygiene, autonomic dysreflexia, gait pattern, positioning, and other criteria, though not all criteria tested showed improvement in all studies. Significant adverse effects were not reported in any of the studies. [31]

A systematic review of BoNT-A therapy in poststroke spasticity by Rosales et al found an odds ratio of 4.5 (95% confidence index 2.79-7.25) for an improvement of 1 or more points on the Modified Ashworth Scale at 4-6 weeks after BoNT-A treatment. [32]

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