CLINICAL EFFECT OF BOTULINUM TOXIN TYPE A IN TREATMENT OF SPASTICITY

NCT ID: NCT04673240

Last Updated: 2020-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

70 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-03-29

Study Completion Date

2022-06-30

Brief Summary

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Spasticity has been defined as a disorder of the sensorimotor system characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyperexcitability of the stretch reflex.

The treatment goal of spasticity is Medical treatment generally combines physiotherapy with medications, depending on spasticity distribution. Systemic treatments such as oral or intrathecal baclofen are generally considered in case of generalized spasticity, whereas local treatments are considered in case of focal spasticity.

Local treatments such as Botulinum Toxin type A, phenol, and alcohol present several advantages, allowing to treat of selected muscles without the risk of sedation. As stated above, they are indicated for focal spasticity but might be helpful even in the presence of generalized spasticity with identified focal goals (Bethoux et al., 2015).

In particular, Botulinum Toxin type A (BoNT-A) is considered the gold standard treatment for focal spasticity, showing a level A evidence for spasticity reduction in upper- and lower-limb spasticity (Simpson et al., 2016).

However, current evidence is mainly focused on post-stroke spasticity (Franceschini et al., 2014), whereas it is still limited in spasticity as a consequence of other aetiologies, such as spinal cord injury (SCI), traumatic brain injury (TBI), or multiple sclerosis (MS).

Interestingly, spasticity is a major concern for the rehabilitation of these patients.

The aim of this observational study is the evaluation of the clinical efficacy of BoNT-A in spasticity reduction in patients affected by neurological conditions different from post-stroke spasticity, such as SCI, TBI, and MS.

Detailed Description

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Conditions

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Spasticity Brain Injuries Spinal Cord Injuries Multiple Sclerosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Interventions

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Botulinum toxin type A injection

Adult patients with spasticity due to traumatic brain injury, spinal cord injury, or MS, treated with Botulinum Toxin type A.

As this is a non-interventional study, no diagnostic, therapeutic, or experimental intervention is involved. Subjects will receive clinical assessments, medications, and treatments solely as determined by their study physician.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age \>18 years
* Spasticity as a consequence of traumatic brain injury, spinal cord injury or MS (documented by clinical records)
* Muscle tone graded at least 1+ on the modified Ashworth scale in the relevant joints of the affected limb(s), which requires medical intervention
* BoNT naïve or pre-treated with any BoNT product. If previously treated with any BoNT, at least a 4 months interval between last injection and inclusion

Exclusion Criteria

* Presence of fixed contractures or bony deformities in the affected limb
* Changes in any oral antispastic medications or specific physiotherapy regimen \<4m before study entry or during the study.
* Other neurological or orthopaedic conditions involving the affected limbs.
* Sensitivity to BoNT-A or to its excipients
* Other contraindications as given in the local SmPC for BoNT-A
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ipsen

INDUSTRY

Sponsor Role collaborator

Azienda Ospedaliero Universitaria Maggiore della Carita

OTHER

Sponsor Role collaborator

SIRN

UNKNOWN

Sponsor Role collaborator

Università degli Studi del Piemonte Orientale Amedeo Avogadro

OTHER

Sponsor Role lead

Responsible Party

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Alessio Baricich

MD PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alessio Baricich

Role: STUDY_CHAIR

Università del Piemonte orientale "Amedeo Avogadro"

Locations

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Azienda Ospedaliero Universitaria Maggiore della Carità

Novara, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Alessio Baricich

Role: CONTACT

Phone: 03213734805

Email: [email protected]

Roberta Carozzi

Role: CONTACT

Phone: 0321 3734805

Facility Contacts

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Alessio Baricich, MDPhD

Role: primary

References

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Baricich A, Battaglia M, Cuneo D, Cosenza L, Millevolte M, Cosma M, Filippetti M, Dalise S, Azzollini V, Chisari C, Spina S, Cinone N, Scotti L, Invernizzi M, Paolucci S, Picelli A, Santamato A. Clinical efficacy of botulinum toxin type A in patients with traumatic brain injury, spinal cord injury, or multiple sclerosis: An observational longitudinal study. Front Neurol. 2023 Apr 6;14:1133390. doi: 10.3389/fneur.2023.1133390. eCollection 2023.

Reference Type DERIVED
PMID: 37090974 (View on PubMed)

Other Identifiers

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NSS_BoNT-A

Identifier Type: -

Identifier Source: org_study_id