Evidence map›Paper›PMID 34957963›Full record

Trial reportJournal of pediatric rehabilitation medicine2022

Safety and efficacy of repeat long-term incobotulinumtoxinA treatment for lower limb or combined upper/lower limb spasticity in children with cerebral palsy.

Petr Kaňovský, Florian Heinen, A Sebastian Schroeder, Henry G Chambers, Edward Dabrowski, Thorin L Geister, Angelika Hanschmann, Francisco J Martinez-Torres, Irena Pulte, Marta Banach and 1 more

Open access · bronzeAbstract readClinical Trial, Phase III
In one paragraph

Trial report in Journal of pediatric rehabilitation medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. The state of the art in therapeutic administration of botulinum toxin in children with cerebral palsy: an integrative review.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2024
    Review
  4. The utility of selective partial neurectomy of the musculocutaneous nerve in children with bilateral spastic elbow.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2023
    Article
  5. Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 4 countries.

Petr KaňovskýFaculty of Medicine and Dentistry and University Hospital, Palacký University Olomouc, Olomouc, Czech Republic.
Florian HeinenDepartment of Pediatric Neurology & Developmental Medicine and LMU Center for Children with Medical Complexity, Dr.von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
A Sebastian SchroederDepartment of Pediatric Neurology & Developmental Medicine and LMU Center for Children with Medical Complexity, Dr.von Hauner Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Henry G ChambersRady Children's Hospital, San Diego, CA, USA.
Edward DabrowskiBeaumont Pediatric Physical Medicine & Rehabilitation - Royal Oak, Royal Oak, MI, USA.
Thorin L GeisterMerz Pharmaceuticals Gmb H, Frankfurt am Main, Germany.
Angelika HanschmannMerz Pharmaceuticals Gmb H, Frankfurt am Main, Germany.
Francisco J Martinez-TorresFormerly of Merz North America, Raleigh, NC, USA.
Irena PulteMerz Pharmaceuticals Gmb H, Frankfurt am Main, Germany.
Marta BanachDepartment of Neurology, Collegium Medicum, Jagiellonian University, Krakow, Poland.
Deborah Gaebler-SpiraShirley Ryan AbilityLab, Chicago, IL, USA.
MerLion Pharma (Germany) · DELudwig-Maximilians-Universität München · DEJagiellonian University · PLMerz (United States) · USRady Children's Hospital-San Diego · USRoyal Oak Community Coalition · USShirley Ryan AbilityLab · USUniversity Hospital Olomouc · CZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe open-label phase 3 "Treatment with IncobotulinumtoxinA in Movement Open-Label" (TIMO) study investigated longer-term safety and efficacy of incobotulinumtoxin A in children/adolescents with cerebral palsy (CP).

methodsPatients on standard treatment, with unilateral or bilateral lower limb (LL) or combined upper limb (UL)/LL spasticity received four incobotulinumtoxinA injection cycles (16 or 20 Units/kg bodyweight total [maximum 400 or 500 Units] per cycle depending on ambulatory status/clinical pattern treated), each followed by 12-16 weeks' observation. Treatment for pes equinus was mandatory; flexed knee or adducted thigh were options for unilateral treatment and/or ULs for unilateral/bilateral treatment. The primary endpoint was safety; changes in Ashworth Scale and Gross Motor Function Measure-66 scores, and Global Impression of Change Scale scores at week 4 of each injection cycle were also evaluated.

resultsIncobotulinumtoxinA (≤500 Units for ≤98 weeks) was safe, well-tolerated, and effective across all endpoints for multipattern treatment of LL and combined LL/UL spasticity in ambulant/nonambulant children/adolescents with CP. Treatment effects increased with each injection cycle. No new/unexpected safety concerns were identified.

conclusionIncobotulinumtoxinA showed a good safety and tolerability profile, with efficacy over multiple clinical presentations. As an adjunct treatment, it offers an effective, individualized treatment option for pediatric CP-related spasticity.

Indexed as

Botulinum Toxins, Type ACerebral PalsyNeuromuscular AgentsAdolescentChildHumansLower ExtremityMuscle SpasticityTreatment OutcomeBotulinum Toxins, Type AincobotulinumtoxinANeuromuscular AgentsBotulinum toxinscerebral palsymovement disordersmuscle spasticitypaediatricType A

Identifiers

PMID34957963
PMCPMC9028655
OpenAlexW4200023027

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.