Observational studyNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2020
Botulinum toxin for the management of spasticity in multiple sclerosis: the Italian botulinum toxin network study.
Observational study in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- AbobotulinumtoxinA Doses in Upper and Lower Limb Spasticity: A Systematic Literature Review.Toxins · 2022Pooled it
- IncobotulinumtoxinA for the treatment of lower-limb spasticity in children and adolescents with cerebral palsy: A phase 3 study.Journal of pediatric rehabilitation medicineTrial
- A proof-of-concept study on the effectiveness of botulinum toxin on spasticity plus syndrome in multiple sclerosis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2026Article
- Botulinum toxin treatment for multiple sclerosis and post-stroke spasticity in clinical practice: differences in injection doses and patterns.Frontiers in rehabilitation sciences · 2026Article
- Spasticity Management with Botulinum Toxin in Post-stroke and Multiple Sclerosis Patients: A Retrospective, 'Real-world', Multicenter Study.NeuroRehabilitation · 2025Observational
- Spasticity patterns assessment and recognition for therapeutic approaches (SPARTA) in multiple sclerosis: a multicenter epidemiological study.Journal of neurology · 2024Article
- Multiple sclerosis and spasticity: the role of anaesthetic nerve blocks on rectus femoris muscle. When should stiff knee be treated with botulinum toxin?Journal of rehabilitation medicine · 2024Observational
- Botulinum toxin in clinical practice: state of the art of administration provisions in Italy.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2023Article
- Trends in Botulinum Toxin Use among Patients with Multiple Sclerosis: A Population-Based Study.Toxins · 2023Article
- Persistence with Botulinum Toxin Treatment for Spasticity Symptoms in Multiple Sclerosis.Toxins · 2022Article
- [Pain in multiple sclerosis and neuromyelitis optica spectrum disorders].Schmerz (Berlin, Germany) · 2021Article
- A combined therapeutic approach: extracorporeal shock wave therapy and botulinum toxin in multiple sclerosis-related spasticity.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
29 authors at 19 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBotulinum toxin (BT) is an effective and safe treatment for spasticity, with limited evidence in multiple sclerosis (MS). We aim to describe the use of BT for the management of MS spasticity in the clinical practice, its combination with other anti-spastic treatments in MS and possible MS clinical correlates.
methodsThis is a multicentre cross-sectional observational study including 386 MS patients, receiving BT for spasticity in 19 Italian centres (age 53.6 ± 10.9 years; female 228 (59.1%); disease duration 18.7 ± 9.2 years; baseline Expanded Disability Status Scale (EDSS) 6.5 (2.0-9.0)).
resultsBT was used for improving mobility (n = 170), functioning in activities of daily living (n = 56), pain (n = 56), posturing-hygiene (n = 63) and daily assistance (n = 41). BT formulations were AbobotulinumtoxinA (n = 138), OnabotulinumtoxinA (n = 133) and IncobotulinumtoxinA (n = 115). After conversion to unified dose units, higher BT dose was associated with higher EDSS (Coeff = 0.591; p < 0.001), higher modified Ashworth scale (Coeff = 0.796; p < 0.001) and non-ambulatory patients (Coeff = 209.382; p = 0.006). Lower BT dose was used in younger patients (Coeff = - 1.746; p = 0.009), with relapsing-remitting MS (Coeff = - 60.371; p = 0.012). BT dose was higher in patients with previous BT injections (Coeff = 5.167; p = 0.001), and with concomitant treatments (Coeff = 43.576; p = 0.022). Three patients (0.7%) reported on post-injection temporary asthenia/weakness (n = 2) and hypophonia (n = 1).
conclusionBT was used for spasticity and its consequences from the early stages of MS, without significant adverse effects. MS-specific goals and injection characteristics can be used to refer MS patients to BT treatment, to decide for the strategy of BT injections and to guide the design of future clinical trials and observational studies.
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