SynthesisPM & R : the journal of injury, function, and rehabilitation2026
Effects of incobotulinumtoxinA in children and adolescents with spastic cerebral palsy: A systematic review of randomized controlled trials.
Synthesis in PM & R : the journal of injury, function, and rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled 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.
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.
Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Effects of incobotulinumtoxinA in children and adolescents with spastic cerebral palsy: A systematic review of randomized controlled trials.PM & R : the journal of injury, function, and rehabilitation · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the effects of incobotulinumtoxinA (incoBoNT-A) in children and adolescents with spastic cerebral palsy (CP). LITERATURE SURVEY: CP is a leading cause of childhood disability, with spasticity present in >90% of cases. BoNT-A is widely used to manage spasticity, improving function and quality of life. IncoBoNT-A, a highly purified BoNT-A formulation, offers reduced immunogenicity and greater stability across storage conditions. Although previous reviews have evaluated BoNT-A in CP, none have focused specifically on incoBoNT-A. METHODOLOGY: For this systematic review, we searched databases and trial registries through February 2025 for randomized controlled trials (RCTs) comparing incoBoNT-A with placebo, other BoNT-A formulations, or different doses in patients ≤18 years with spastic CP. Meta-analyses used random- or fixed-effects models; evidence certainty was rated with Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. SYNTHESIS: We included four RCTs. IncoBoNT-A showed very uncertain effects compared to onabotulinumtoxinA (onaBoNT-A) on spasticity, gait, and adverse events. Higher doses of incoBoNT-A (≥6 units/kg) showed minimal improvement in spasticity (mean difference: -0.19, 95% confidence interval [CI]: -0.36 to -0.01; moderate certainty) compared to lower doses (≤4 units/kg), with no meaningful differences in motor function, global impression of change, or adverse events. Certainty ranged from moderate to very low.
conclusionsThe available evidence is insufficient to determine whether incoBoNT-A offers any advantages or disadvantages compared to onaBoNT-A in children with spastic CP, given the very low certainty of the data. Similarly, using a higher dose of incoBoNT-A is unlikely to yield a meaningful clinical benefit compared to a lower dose. Further high-quality trials are needed to reduce uncertainty and guide clinical decision-making.
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Registered trials
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.