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Benefit of multiple incobotulinumtoxinA injections for pain reduction in adult patients with limb spasticity: an analysis of pooled data from phase 2 and 3 studies

J. Wissel, A. Camões-Barbosa2, G. Comes, M. Althaus, A. Scheschonka, D. Simpson (Potsdam, Germany)

Meeting: 2022 International Congress

Abstract Number: 906

Keywords: Botulinum toxin: Clinical applications: spasticity, Pain, Spasticity: Treatment

Category: Spasticity

Objective: To assess pain relief after multiple incoA injections in a large sample of pts with limb spasticity-associated pain (SAP) using pooled data from six phase 2/3 studies (four placebo-controlled).

Background: Repeated treatment with incobotulinumtoxinA (incoA) has shown pain-relieving benefits in patients (pts) with limb spasticity in individual studies.

Method: Adults with upper limb SAP received up to 4 incoA injections (total dose ≤400U) administered at 12- to 14-week intervals (injection cycles [ICs] 1–4; total observation period up to 56 weeks). Only IC 1 was placebo-controlled. Pain severity was assessed at control visits (CVs; 4 weeks after each injection) using the Disability Assessment Scale (DAS; pain scores ranging from 0 [no pain] to 3 [severe pain]). The proportions of pts with a response (defined as a reduction by ≥1 point in the DAS score from baseline to each CV) and with a complete response (DAS pain score=0) were assessed at every CV. Data were descriptively analyzed. As placebo-treated pts in IC 1 received incoA in subsequent cycles, they contributed data to the appropriate incoA CVs 1–4.

Results: 515 pts with SAP at baseline were included in this analysis (515, 297, 263, and 181 pts at CVs 1–4, respectively). Response rates increased over time, being 53.0%, 63.3%, 66.9%, and 72.4% at CVs 1–4, respectively. Likewise, the proportion of pts with complete response increased over time, being 27.6%, 38.4%, 39.5%, and 43.6% at CVs 1–4, respectively.

Conclusion: In pts with upper limb SAP, treatment response rates were sustained and showed a cumulative effect over 56 weeks after multiple incoA injections, with a complete pain relief in >40.0% of pts. Results support the use of incoA in reducing upper limb SAP in affected adults.

To cite this abstract in AMA style:

J. Wissel, A. Camões-Barbosa2, G. Comes, M. Althaus, A. Scheschonka, D. Simpson. Benefit of multiple incobotulinumtoxinA injections for pain reduction in adult patients with limb spasticity: an analysis of pooled data from phase 2 and 3 studies [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/benefit-of-multiple-incobotulinumtoxina-injections-for-pain-reduction-in-adult-patients-with-limb-spasticity-an-analysis-of-pooled-data-from-phase-2-and-3-studies/. Accessed May 14, 2025.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/benefit-of-multiple-incobotulinumtoxina-injections-for-pain-reduction-in-adult-patients-with-limb-spasticity-an-analysis-of-pooled-data-from-phase-2-and-3-studies/

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