Effects of repeated abobotulinumtoxinA injections in upper limb spasticity

• Published in: Muscle & nerve Vol. 57; no. 2; pp. 245 - 254
• Main Authors: Gracies, Jean‐Michel, O'Dell, Michael, Vecchio, Michele, Hedera, Peter, Kocer, Serdar, Rudzinska‐Bar, Monika, Rubin, Bruce, Timerbaeva, Sofiya L., Lusakowska, Anna, Boyer, François Constant, Grandoulier, Anne‐Sophie, Vilain, Claire, Picaut, Philippe
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.02.2018; Wiley; John Wiley and Sons Inc
• Subjects: active function; Adult; Adults; Aged; botulinum toxin; Botulinum Toxins, Type A - administration & dosage; Botulinum Toxins, Type A - adverse effects; Botulinum Toxins, Type A - therapeutic use; Clinical Research; Disability Evaluation; Double-Blind Method; Elbow; Elbow (anatomy); Elbow - physiopathology; Female; Fingers - physiopathology; Flexors; Humans; Injections, Intramuscular; Life Sciences; Male; Middle Aged; Muscle Spasticity - drug therapy; Muscle Spasticity - physiopathology; Muscle Tonus - drug effects; Muscles; Neuromuscular Agents - administration & dosage; Neuromuscular Agents - adverse effects; Neuromuscular Agents - therapeutic use; open label; Range of Motion, Articular - drug effects; Safety; Spasticity; stroke; traumatic brain injury; Treatment Outcome; Upper Extremity - physiopathology; upper limb spasticity; Wrist; Wrist - physiopathology; botulinum toxin; traumatic brain injury; upper limb spasticity; open label; stroke; active function
• ISSN: 0148-639X; 1097-4598; 1097-4598
• DOI: 10.1002/mus.25721

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