Evidence map›Paper›PMID 39728771›Full record

ArticleToxins2024

Are We Missing Something About the Maximum Dosing of Botulinum Toxin Type A1 in Adult and Pediatric Patients with Spasticity?

Alessandro Picelli, Rita Di Censo, Stefano Tamburin, Nicola Smania, Mirko Filippetti

Abstract read
In one paragraph

Article in Toxins, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Alessandro PicelliDepartment of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.ORCID 0000-0002-3558-8276
Rita Di CensoDepartment of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.ORCID 0000-0002-8017-4013
Stefano TamburinDepartment of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.ORCID 0000-0002-1561-2187
Nicola SmaniaDepartment of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.ORCID 0000-0001-7630-1887
Mirko FilippettiDepartment of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy.ORCID 0000-0001-5930-5974

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Botulinum toxin type A1 is a first-line treatment for adult and pediatric spasticity. However, when considering the quantity of 150 kDa neurotoxin protein in relation to patient weight and the maximum recommended dose for treating adult and pediatric patients with spasticity, several concerns arise. First, the therapeutic margin (the ratio of the actual maximum quantity of toxin recommended for treating adult spasticity to its median lethal dose) appears to be relevant. Second, there is no consistency between adult and pediatric dosing of botulinum toxin type A1 for spasticity. The third point concerns the suitability of the recommended doses for treating spasticity in pediatric patients. Based on the average body weight of American children and adolescents, the maximum weight-based doses for abobotulinumtoxinA and onabotulinumtoxinA could be administered to children as young as 9 years old. Additionally, the maximum weight-based dose for incobotulinumtoxinA could be administered to children as young as 6 years old. The final point concerns managing the maximum dose of BoNT/A1 in pediatric patients with spasticity who weigh more than 25 kg for incobotulinumtoxinA, or more than 34 kg for abobotulinumtoxinA and onabotulinumtoxinA. No labeled recommendations are given on the weight cut-off for transitioning to adult dosing in pediatric patients.

Indexed as

Botulinum Toxins, Type AMuscle SpasticityNeuromuscular AgentsAdolescentAdultBody WeightChildHumansabobotulinumtoxinABotulinum Toxins, Type ANeuromuscular Agentsbotulinum toxinsmuscle spasticitytherapeutics

Identifiers

PMID39728771
PMCPMC11728732

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Registered trials

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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.