Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2015 Mar;94(3):229-38.
doi: 10.1097/PHM.0000000000000208.

Systematic literature review of abobotulinumtoxinA in clinical trials for adult upper limb spasticity

Khashayar Dashtipour  1 , Jack J Chen, Heather W Walker, Michael Y Lee
Affiliations
Meta-Analysis

Systematic literature review of abobotulinumtoxinA in clinical trials for adult upper limb spasticity

Khashayar Dashtipour et al. Am J Phys Med Rehabil. 2015 Mar.

Abstract

Objective: The aim of this study was to elucidate clinical trial efficacy, safety, and dosing practices of abobotulinumtoxinA (ABO) treatment in adult patients with upper limb spasticity (ULS).

Methods: A systematic literature review was performed to identify randomized controlled trials and other comparative clinical studies of ABO in the treatment of adult ULS published in English between January 1991 and January 2013. Medical literature databases (PubMed, Cochrane Library, and EMBASE) were searched, and a total of 295 records were identified. Of these, 12 primary publications that evaluated ABO for the management of ULS were included in the final data report.

Synthesis: Total ABO doses ranged between 500 and 1500 U for ULS. Most of the studies in ULS showed statistically significant benefits (reduction in muscle tone based on Ashworth score) of ABO vs. placebo. Statistical significance was reached for most evaluations of spasticity using the Modified Ashworth Scale. Statistically significant effects on active movement and pain were demonstrated, albeit less consistently. ABO was generally well tolerated across the individual studies; most adverse events reported were considered unrelated to treatment. Adverse events considered associated with ABO treatment included fatigue, tiredness, arm pain, skin rashes, flu-like symptoms, worsening of spasm, and weakness.

Conclusions: On the basis of data extracted from 12 randomized clinical studies, a strong evidence base (9/12 studies) exists for the use of ABO to reduce ULS caused by stroke.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram reporting the results of the systematic literature search.
See this image and copyright information in PMC

References

    1. Royal College of Physicians, British Society of Rehabilitation Medicine, Chartered Society of Physiotherapy, Association of Chartered Physiotherapists Interested in Neurology. Spasticity in adults: management using botulinum toxin. National guidelines. London: RCP, 2009.
    1. Esquenazi A, Mayer NH, Elia AE, et al. : Botulinum toxin for the management of adult patients with upper motor neuron syndrome. Toxicon 2009; 54: 634– 8 - PubMed
    1. Simpson DM, Gracies JM, Graham K, et al. : Assessment: Botulinum neurotoxin for the treatment of spasticity (an evidence-based review). Neurology 2009; 73: 736– 7; author reply 737–8 - PubMed
    1. Esquenazi A, Albanese A, Chancellor MB, et al. : Evidence-based review and assessment of botulinum neurotoxin for the treatment of adult spasticity in the upper motor neuron syndrome. Toxicon 2013; 67: 115– 28 - PubMed
    1. Foley N, Pereira S, Salter K, et al. : Treatment with botulinum toxin improves upper-extremity function post stroke: A systematic review and meta-analysis. Arch Phys Med Rehabil 2013; 94: 977– 89 - PubMed

Publication types

MeSH terms

Substances