Contributions
Abstract: EP1380
Type: ePoster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Background and Purpose: Limited research has been conducted evaluating the benefits of Intrathecal Baclofen Therapy (ITBT) in Multiple Sclerosis (MS) patients, specifically ambulatory patients. This study demonstrates a possible ITBT patient care model for patients with MS in the clinical setting.
Methods: Post Hoc chart reviews completed at MS Center at Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA, a multidisciplinary MS clinic offering ITBT for previous 6 years. Review included standard MS care, ITBT screening, referral and monitoring process, continued ITBT management and functional outcome measures. Demographics, disease status and clinical outcomes were compared with overall MS population.
Results: Clinic model of ITBT treatment sequence: Identification by provider; Physical Therapy (PT) evaluation; ITBT trial with PT monitoring; decision of patient with providers for surgical referral and surgical pump implantation; ongoing management of ITBT dose, rehabilitation, and MS care.
Demographics Data (n=54):
Patient gender ratios; percentages of Relapsing Remitting MS, Primary Progressive MS, Secondary Progressive MS, and Neuromyelitis Optica mirrored general MS population.
Clinical Care Data:
Average time since diagnosis: 17 years ±15; Average time ITBT 42.3 months ±38; gait speeds stable over 24 months of ITBT; no preference indication of Disease Modifying Therapies; 54% required additional oral antispasmodics or onabotulinumtoxin A injections; average daily dose of baclofen was 470.29micg/day.
Discussion: An integrated referral model can be used to identify and effectively treat MS patients with spasticity. OMRF patients mirrored demographics of general MS population. Ambulatory patients' function remained stable over 24 months. Average daily dose and use of additional antispasmodics are also consistent with literature. ITBT in MS clinics using this model can be used to treat spasticity as comprehensive symptom management. Further research regarding decision algorithms and functional outcomes need to be addressed.
Conclusion: Management of ITBT in MS patients includes similar demographics to the MS population. This ITBT model may be used as guide for clinics to implement ITBT. Additional antispasmodic may be required for optimal spasticity management in MS patients.
Disclosure: Amy Thiessen, PT, MEd, has the following disclosure: speaker for Accorda Therapeutics.
Jennifer Smith, PA-C, has the following disclosures: speaker for Teva and Genzyme, consultant for Genentech and EMD Serano.
Tania Reyna, MD: nothing to disclose.
Abstract: EP1380
Type: ePoster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Background and Purpose: Limited research has been conducted evaluating the benefits of Intrathecal Baclofen Therapy (ITBT) in Multiple Sclerosis (MS) patients, specifically ambulatory patients. This study demonstrates a possible ITBT patient care model for patients with MS in the clinical setting.
Methods: Post Hoc chart reviews completed at MS Center at Oklahoma Medical Research Foundation (OMRF), Oklahoma City, Oklahoma, USA, a multidisciplinary MS clinic offering ITBT for previous 6 years. Review included standard MS care, ITBT screening, referral and monitoring process, continued ITBT management and functional outcome measures. Demographics, disease status and clinical outcomes were compared with overall MS population.
Results: Clinic model of ITBT treatment sequence: Identification by provider; Physical Therapy (PT) evaluation; ITBT trial with PT monitoring; decision of patient with providers for surgical referral and surgical pump implantation; ongoing management of ITBT dose, rehabilitation, and MS care.
Demographics Data (n=54):
Patient gender ratios; percentages of Relapsing Remitting MS, Primary Progressive MS, Secondary Progressive MS, and Neuromyelitis Optica mirrored general MS population.
Clinical Care Data:
Average time since diagnosis: 17 years ±15; Average time ITBT 42.3 months ±38; gait speeds stable over 24 months of ITBT; no preference indication of Disease Modifying Therapies; 54% required additional oral antispasmodics or onabotulinumtoxin A injections; average daily dose of baclofen was 470.29micg/day.
Discussion: An integrated referral model can be used to identify and effectively treat MS patients with spasticity. OMRF patients mirrored demographics of general MS population. Ambulatory patients' function remained stable over 24 months. Average daily dose and use of additional antispasmodics are also consistent with literature. ITBT in MS clinics using this model can be used to treat spasticity as comprehensive symptom management. Further research regarding decision algorithms and functional outcomes need to be addressed.
Conclusion: Management of ITBT in MS patients includes similar demographics to the MS population. This ITBT model may be used as guide for clinics to implement ITBT. Additional antispasmodic may be required for optimal spasticity management in MS patients.
Disclosure: Amy Thiessen, PT, MEd, has the following disclosure: speaker for Accorda Therapeutics.
Jennifer Smith, PA-C, has the following disclosures: speaker for Teva and Genzyme, consultant for Genentech and EMD Serano.
Tania Reyna, MD: nothing to disclose.