Contributions
Abstract: EP1557
Type: ePoster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Background: Spasticity is a common and impairing symptom in multiple sclerosis (MS) patients, often associated to sleep disorders, bladder dysfunction, pain, and mobility impairment. Its first line pharmacologic treatment is composed by a number of drugs which have been available for decades, some with limited evidence on effectiveness and often a cumbersome tolerability profile.
Aim: To describe the MS spasticity prevalence and the first line generalized spasticity drug treatment preferences, the available generalized antispasticity medications" effectiveness and tolerability perceptions and the overall satisfaction with them from Spanish MS specialists.
Methods: An on-line survey on MS spasticity presence and management developed by the coordination board was sent Q4 2015 to the majority of MS treating centres in Spain.
Results: 152 MS specialists from 110 centres participated. The sample included all MS Units in the country and the main Neurology Services. All of them answered the survey. The average number of MS patients visited by year per involved centre was 386 (SD 133), representing overall more than 90% of the country"s estimated number of MS patients. MS patients" disability prevalence estimation was as follows: EDSS < 3 in 43% of patients, 3 to 6 in 33.6% and >6 in the remaining 23.4%.
The estimated prevalence of spasticity was 36.6% on average.
The main surveyed variables regarding generalized spasticity drug treatment were: use in their centre, use as first choice, frequency of disturbing adverse events and overall satisfaction. The reported answers percentages were respectively: for baclofen: 98.7, 82.7, 10.7 and 57.3; for tizanidine: 76.3, 23.8, 22.4, and 34.5; for clonazepam: 52.6, 7.8, 28.8, and 35.2; for diazepam: 46.7, 3.9, 40.8, and 19.7, and for gabapentin: 48.7, 4.5, 63.5, and 21.6. Differences within parameters figures were stat. significant between drugs. Dantrolene was only (rarely) used in 5 centres.
Conclusions: MS spasticity in Spain is common and not restricted only to high EDSS score patients. Baclofen is the gold standard for MS generalized spasticity first line treatment, while other drugs are clearly less preferred. Satisfaction is not high even for baclofen, and remarkably low for gabapentin and diazepam, pointing towards the limited risk/benefit ratio of these medications in this condition. Benzodiazepines and gabapentin present the most disturbing tolerability profile. Innovative treatment options would be welcomed.
Disclosure: Study supported by an unrestricted grant of Almirall S.A. (Barcelona, Spain)
Abstract: EP1557
Type: ePoster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Background: Spasticity is a common and impairing symptom in multiple sclerosis (MS) patients, often associated to sleep disorders, bladder dysfunction, pain, and mobility impairment. Its first line pharmacologic treatment is composed by a number of drugs which have been available for decades, some with limited evidence on effectiveness and often a cumbersome tolerability profile.
Aim: To describe the MS spasticity prevalence and the first line generalized spasticity drug treatment preferences, the available generalized antispasticity medications" effectiveness and tolerability perceptions and the overall satisfaction with them from Spanish MS specialists.
Methods: An on-line survey on MS spasticity presence and management developed by the coordination board was sent Q4 2015 to the majority of MS treating centres in Spain.
Results: 152 MS specialists from 110 centres participated. The sample included all MS Units in the country and the main Neurology Services. All of them answered the survey. The average number of MS patients visited by year per involved centre was 386 (SD 133), representing overall more than 90% of the country"s estimated number of MS patients. MS patients" disability prevalence estimation was as follows: EDSS < 3 in 43% of patients, 3 to 6 in 33.6% and >6 in the remaining 23.4%.
The estimated prevalence of spasticity was 36.6% on average.
The main surveyed variables regarding generalized spasticity drug treatment were: use in their centre, use as first choice, frequency of disturbing adverse events and overall satisfaction. The reported answers percentages were respectively: for baclofen: 98.7, 82.7, 10.7 and 57.3; for tizanidine: 76.3, 23.8, 22.4, and 34.5; for clonazepam: 52.6, 7.8, 28.8, and 35.2; for diazepam: 46.7, 3.9, 40.8, and 19.7, and for gabapentin: 48.7, 4.5, 63.5, and 21.6. Differences within parameters figures were stat. significant between drugs. Dantrolene was only (rarely) used in 5 centres.
Conclusions: MS spasticity in Spain is common and not restricted only to high EDSS score patients. Baclofen is the gold standard for MS generalized spasticity first line treatment, while other drugs are clearly less preferred. Satisfaction is not high even for baclofen, and remarkably low for gabapentin and diazepam, pointing towards the limited risk/benefit ratio of these medications in this condition. Benzodiazepines and gabapentin present the most disturbing tolerability profile. Innovative treatment options would be welcomed.
Disclosure: Study supported by an unrestricted grant of Almirall S.A. (Barcelona, Spain)