Efficacy of incobotulinumtoxinA for Spasticity-Associated Pain in a Series of Patients with Spasticity of Diverse Etiologies

Abstract

Background: Spasticity is a motor disorder that appears as a cause of upper and lower limb motor disability, frequently causing pain. IncobotulinumtoxinA (IncoA) has proved effective for treating diverse musculoskeletal pathologies, including spasticity and spasticity-related pain. Aims: The aim was to determine the efficacy of IncoA for the treatment of pain associated to limb spasticity of diverse etiologies. Methods: Prospective, single-center study including 30 patients treated with IncoA between May and August 2021 at the University Hospital Center of Central Lisbon (Lisbon, Portugal). Primary endpoint was improvement in spasticity-related pain, assessed by employing pain numerical rating scale for pain at baseline and 12 weeks post-injection, scoring between 0 (no pain) and 10 (severe pain). Results: Patients showed spasticity due to different etiologies, mainly ischemic stroke (46.7%), hemorrhagic stroke (23.3%) and cerebral palsy (20.0%). Mean pain score significantly decreased from baseline (mean: 6.8, range: 2-10) to 12 weeks post-injection (mean: 1.6; range: 0-5). Mean reduction of pain was of -5.2 points (95%CI: -5.9, -4.5). All patients achieved minimum clinically significant difference in pain reduction, showing sustained effect over 12 weeks regardless of spasticity etiology. Conclusion: IncoA may be considered as an alternative for the treatment of spasticity-associated pain of diverse etiologies in upper and lower limbs.