Spasticity Management with Botulinum Toxin in Post-stroke and Multiple Sclerosis Patients: A Retrospective, 'Real-world', Multicenter Study.
Calogera Butera, Marcello Esposito, Trinchillo Assunta and 7 others
PMID 40432515WHAT IT FOUND
Real-world data from 149 patients shows botulinum toxin injection patterns differ substantially between stroke and multiple sclerosis.
Stroke patients often received injections in both limbs at lower doses, while MS patients were primarily treated in the lower limbs with higher doses of one specific formulation.
Key findings
01Patients with MS were significantly more likely to have lower limb spasticity than upper limb spasticity (92% vs 21%), whereas most post-stroke patients (73%) experienced both.
02Higher mean doses of abobotulinumtoxinA were used in MS patients compared with post-stroke patients, while doses for other formulations were more similar between the two groups.
03The majority of patients were satisfied with repeated treatment over several cycles, supporting the effectiveness of botulinum toxin injections in focal spasticity management regardless of etiology.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Retrospective, observational design with no control group. Outcomes were limited to those routinely recorded; goal setting and attainment were not systematically collected. The comparison between post-stroke and MS populations was an exploratory objective. Sample size for other etiologies was too small for meaningful analysis. 61% of patients switched between BoNT-A formulations due to availability, making it difficult to compare effectiveness of specific products. The study could not correlate treatment data with the severity of spasticity.
Declared interests
The study was funded by Ipsen. Several authors were investigators in the study and received payment from Ipsen. One author has extensive financial relationships with multiple pharmaceutical companies.
The easy way to misread this
Do not interpret the satisfaction rates or continuation of treatment as evidence of efficacy compared to no treatment or other interventions, as this was an uncontrolled observational study. The findings describe real-world practice patterns and patient experiences, not causal effects of the intervention.