Abstract: EP1684
Type: Poster Sessions
Abstract Category: Therapy - Symptomatic treatment
Background: Spasticity can result in gait disorders, upper-limb dysfunction and pain. Intramuscular injection of botulinum toxin (BT) has proven efficacy for spasticity in multiple sclerosis (MS) but, so far, little evidence is available on the use of BT in the clinical management of MS. We aim to describe the use of BT in MS, in relation to clinical features and concomitant treatments.
Methods: This is a retrospective observational study within 15 Italian BT network centres. Patients with MS and injected with BT were included. We collected characteristics of BT injections, MS features and concomitant treatments. Linear regression models were used to explore correlates of BT injections; different BT formulations were included as covariates in the statistical models.
Results: We included 281 MS patients (age 53.7±11.3 years; female 59%; EDSS 6.5 [2.5-9.5]). Main goals of BT injection were movement (43%), functioning (18%), pain (15%), hygiene (15%), and ease in daily assistance (9%). Patients underwent 5.8±5.7 BT injections in the past, every 4.5±3.5 months; patients with more injections in the past received higher BT dose (Coeff=11.14; 95%CI=4.77/17.51; p=0.001). Higher BT dose was associated with higher Expanded Disability Status Scale (Coeff=48.40; 95%CI=21.70/75.11; p< 0.001) and with higher Modified Ashworth Scale (Coeff=110.32; 95%CI=56.39/164.25; p< 0.001). BT was the only treatment for spasticity in 48.8% patients, whilst 51.2% patients were treated with 1.4±0.7 concomitant medications; higher BT dose was associated with more concomitant treatments, (Coeff=111.619; 95%CI=41.052/182.185; p=0.002).
Discussion: This is the largest study conducted on the use of BT in MS. BT in monotherapy can be used for spasticity-related symptoms in MS, particularly in less-spastic patients at low dose. Once disease severity increases, higher doses of BT and additional medications can be considered.
Disclosure: Marcello Moccia: has received research grants from MAGNIMS-ECTRIMS and Merck.
Jessica Frau: nothing to disclose.
Antonio Carotenuto: nothing to disclose.
Giancarlo Coghe: nothing to disclose.
Pierangelo Barbero: nothing to disclose.
Marco Frontoni: nothing to disclose.
Morena Giovannelli: nothing to disclose.
Carla Butera: nothing to disclose.
Cristina Inglese: nothing to disclose.
Emma Frasson: nothing to disclose.
Pamela Latino: nothing to disclose.
Maurizio Osio: nothing to disclose.
Stefania Lanfranchi: nothing to disclose.
Marcello Romano: nothing to disclose.
Silvia Lori: nothing to disclose.
Vitalma Liotti: nothing to disclose.
Laura Rapisarda: nothing to disclose.
Francesco Patti: nothing to disclose.
Marcello Esposito: nothing to disclose.
Maria Concetta Altavista: nothing to disclose.
Francesco Bono: nothing to disclose.
Roberto Eleopra: nothing to disclose.
Vincenzo Brescia Morra: has received honoraria from Allergan, Bayer, Biogen, Genzyme, and Merck Serono.
Abstract: EP1684
Type: Poster Sessions
Abstract Category: Therapy - Symptomatic treatment
Background: Spasticity can result in gait disorders, upper-limb dysfunction and pain. Intramuscular injection of botulinum toxin (BT) has proven efficacy for spasticity in multiple sclerosis (MS) but, so far, little evidence is available on the use of BT in the clinical management of MS. We aim to describe the use of BT in MS, in relation to clinical features and concomitant treatments.
Methods: This is a retrospective observational study within 15 Italian BT network centres. Patients with MS and injected with BT were included. We collected characteristics of BT injections, MS features and concomitant treatments. Linear regression models were used to explore correlates of BT injections; different BT formulations were included as covariates in the statistical models.
Results: We included 281 MS patients (age 53.7±11.3 years; female 59%; EDSS 6.5 [2.5-9.5]). Main goals of BT injection were movement (43%), functioning (18%), pain (15%), hygiene (15%), and ease in daily assistance (9%). Patients underwent 5.8±5.7 BT injections in the past, every 4.5±3.5 months; patients with more injections in the past received higher BT dose (Coeff=11.14; 95%CI=4.77/17.51; p=0.001). Higher BT dose was associated with higher Expanded Disability Status Scale (Coeff=48.40; 95%CI=21.70/75.11; p< 0.001) and with higher Modified Ashworth Scale (Coeff=110.32; 95%CI=56.39/164.25; p< 0.001). BT was the only treatment for spasticity in 48.8% patients, whilst 51.2% patients were treated with 1.4±0.7 concomitant medications; higher BT dose was associated with more concomitant treatments, (Coeff=111.619; 95%CI=41.052/182.185; p=0.002).
Discussion: This is the largest study conducted on the use of BT in MS. BT in monotherapy can be used for spasticity-related symptoms in MS, particularly in less-spastic patients at low dose. Once disease severity increases, higher doses of BT and additional medications can be considered.
Disclosure: Marcello Moccia: has received research grants from MAGNIMS-ECTRIMS and Merck.
Jessica Frau: nothing to disclose.
Antonio Carotenuto: nothing to disclose.
Giancarlo Coghe: nothing to disclose.
Pierangelo Barbero: nothing to disclose.
Marco Frontoni: nothing to disclose.
Morena Giovannelli: nothing to disclose.
Carla Butera: nothing to disclose.
Cristina Inglese: nothing to disclose.
Emma Frasson: nothing to disclose.
Pamela Latino: nothing to disclose.
Maurizio Osio: nothing to disclose.
Stefania Lanfranchi: nothing to disclose.
Marcello Romano: nothing to disclose.
Silvia Lori: nothing to disclose.
Vitalma Liotti: nothing to disclose.
Laura Rapisarda: nothing to disclose.
Francesco Patti: nothing to disclose.
Marcello Esposito: nothing to disclose.
Maria Concetta Altavista: nothing to disclose.
Francesco Bono: nothing to disclose.
Roberto Eleopra: nothing to disclose.
Vincenzo Brescia Morra: has received honoraria from Allergan, Bayer, Biogen, Genzyme, and Merck Serono.