• J Rehabil Med · May 2011

    Multicenter Study Clinical Trial

    Efficacy and safety of treatment with incobotulinum toxin A (botulinum neurotoxin type A free from complexing proteins; NT 201) in post-stroke upper limb spasticity.

    • Petr Kaňovský, Jaroslaw Slawek, Zoltan Denes, Thomas Platz, Georg Comes, Susanne Grafe, and Irena Pulte.
    • Department of Neurology, Palacky University Medical School University Hospital, IP Pavlova 6, CZ-775 20 Olomouc, Czech Republic. petr.kanovsky@fnol.cz
    • J Rehabil Med. 2011 May 1;43(6):486-92.

    ObjectiveTo investigate the efficacy and safety of repeated treatment with incobotulinum toxin A (botulinum neurotoxin type A free from complexing proteins; NT 201) in post-stroke upper limb spasticity.Patients And DesignAfter completing a double-blind, placebo- controlled, multicentre study (up to 20 weeks), 145 patients received up to 5 additional sets of NT 201 injections for an open-label extension period of up to 69 weeks.MethodsUpper limb muscle groups were treated as clinically indicated; injection intervals were ≥ 12 weeks. Outcome was assessed 4 weeks after each injection session and at the end of the study.ResultsMuscle tone (flexors of wrist, elbow, finger, and thumb, and forearm pronators) improved throughout the study (response rate: up to 80.6%, p < 0.0001, Ashworth Scale). Continuous and significant improvements were also observed in disability (p < 0.05, Disability Assessment Scale). The majority of investigators, patients and caregivers rated NT 201 efficacy as very good or good (56-84%). Adverse events considered treatment-related occurred in 11% of patients. Formation of neutralizing antibodies was not observed in any patient after repeated treatments.ConclusionTreatment with NT 201 showed sustained improvements in muscle tone and functionality (median dose 400 units) over a study duration of up to 89 weeks, and was well tolerated during repeated treatments for post-stroke upper limb spasticity.

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