Evidence map›Paper›PMID 36287945›Full record

ArticleToxins2022

Reasons and Determinants of BoNT-A Treatment Discontinuation in Patients Living with Spasticity: A 10-Year Retrospective Analysis.

Nicoletta Cinone, Luigi Santoro, Stefania Spina, Salvatore Facciorusso, Marco Battaglia, Alessio Baricich, Pasqua Marcogiuseppe, Andrea Santamato

Open access · goldAbstract read
In one paragraph

Article in Toxins, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.0field-weighted citation impact, top 23% 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

6 citing papers in PubMed, 11 citations in OpenAlex.

  1. Article
  2. Observational
  3. Observational
  4. Article
  5. Review
  6. 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

8 authors at 3 institutions in 1 country.

Nicoletta CinoneSpasticity and Movement Disorder Unit, Physical Medicine and Rehabilitation, Policlinico Riuniti, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy.ORCID 0000-0002-5389-3290
Luigi SantoroSpasticity and Movement Disorder Unit, Physical Medicine and Rehabilitation, Policlinico Riuniti, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy.
Stefania SpinaSpasticity and Movement Disorder Unit, Physical Medicine and Rehabilitation, Policlinico Riuniti, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy.ORCID 0000-0002-7220-4016
Salvatore FacciorussoVilla Beretta Rehabilitation Center, Valduce Hospital, Via Nazario Sauro 17, 23845 Costa Masnaga, Italy.ORCID 0000-0001-6748-9152
Marco BattagliaPhysical Medicine and Rehabilitation, Department of Health Sciences, Università del Piemonte Orientale, viale Piazza d'armi 1, 28100 Novara, Italy.ORCID 0000-0003-1357-1374
Alessio BaricichPhysical Medicine and Rehabilitation, Department of Health Sciences, Università del Piemonte Orientale, viale Piazza d'armi 1, 28100 Novara, Italy.ORCID 0000-0001-8440-6283
Pasqua MarcogiuseppeSpasticity and Movement Disorder Unit, Physical Medicine and Rehabilitation, Policlinico Riuniti, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy.
Andrea SantamatoSpasticity and Movement Disorder Unit, Physical Medicine and Rehabilitation, Policlinico Riuniti, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy.ORCID 0000-0002-1452-8485
University of Foggia · ITUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro” · ITOspedale Valduce · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe present study aimed to evaluate the reasons and determinants of BoNT-A discontinuation in patients with stroke, multiple sclerosis, spinal cord injury, and traumatic brain injury.

methodsIt is a retrospective study of 56 discontinuer patients treated with botulinum toxin between January 2011 and December 2021. Discontinuation rates and their predictors were estimated using Kaplan-Meier, Log rank test, and Cox's regression method of analyses.

resultsThe mean age was 56.54 years, 53.57% were affected by post-stroke spasticity, 17.86% by spinal cord injury, 12.5% and 16.07% by traumatic brain injury and multiple sclerosis, respectively. The median discontinuation time was 5 months. The main reason for discontinuation were logistic problems (37%) and orthopedic surgeries or intrathecal baclofen (27%). Discontinuers were more likely to have severe spasticity (R = 1.785), have no pain (HR = 1.320), no access to rehabilitation services (HR = 1.402), and have cognitive impairment (HR = 1.403).

conclusionsThe main reasons for discontinuation are related to logistic issues (due to distance or the absence of an adequate caregiver) and surgical interventions for spasticity, including intrathecal baclofen. It is crucial to identify possible predictors of discontinuation to improve the effectiveness of a multidisciplinary management. The study confirms the crucial role of rehabilitation and caregivers in achieving better long-term outcomes.

Indexed as

Botulinum Toxins, Type ABrain Injuries, TraumaticMultiple SclerosisNeuromuscular AgentsSpinal Cord InjuriesStrokeBaclofenHumansMiddle AgedMuscle SpasticityRetrospective StudiesTreatment OutcomeBaclofenBotulinum Toxins, Type AincobotulinumtoxinANeuromuscular Agentsbotulinum toxindiscontinuationspasticity

Identifiers

PMID36287945
PMCPMC9609474
OpenAlexW4298146784

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.