Post Hoc Subgroup Analysis of the BCause Study Assessing the Effect of AbobotulinumtoxinA on Post-Stroke Shoulder Pain in Adults

Toxins (Basel). 2022 Nov 20;14(11):809. doi: 10.3390/toxins14110809.

Abstract

Botulinum toxin type A is approved for the focal treatment of spasticity; however, the effectiveness of abobotulinumtoxinA (aboBoNT-A) in patients with shoulder pain who have set reduced pain as a treatment goal is understudied. In addition, some patients encounter delays in accessing treatment programs; therefore, the suitability of aboBoNT-A for pain reduction in this population requires investigation. These factors were assessed in aboBoNT-A-naive Brazilian patients in a post hoc analysis of data from BCause, an observational, multicenter, prospective study (NCT02390206). Patients (N = 49, n = 25 female; mean (standard deviation) age of 60.3 (9.1) years; median (range) time since onset of spasticity of 16.1 (0-193) months) received aboBoNT-A injections to shoulder muscles in one or two treatment cycles (n = 47). Using goal attainment scaling (GAS), most patients achieved their goal of shoulder pain reduction after one treatment cycle (72.1%; 95% confidence interval: 57.2-83.4%). Improvements in GAS T-score from baseline, clinically meaningful reductions in pain score at movement, and clinically meaningful increases in passive shoulder abduction angle further improved with repeated treatment more than 4 months later, despite treatment starting at a median of 16.1 months after the onset of spasticity. These findings support the further investigation of aboBoNT-A injections in chronic post-stroke shoulder pain.

Keywords: abobotulinumtoxinA; patients; post-stroke; shoulder pain; spasticity; therapeutic goal.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Botulinum Toxins, Type A* / therapeutic use
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Spasticity / drug therapy
  • Muscle Spasticity / etiology
  • Prospective Studies
  • Shoulder Pain / drug therapy
  • Shoulder Pain / etiology
  • Shoulder*

Substances

  • abobotulinumtoxinA
  • Botulinum Toxins, Type A

Grants and funding

This research was funded by Ipsen. Ipsen were involved in the design of the study and decision to publish the results. Ipsen provided funding for medical writing support for this manuscript, and internal stakeholders have reviewed the content prior to publication. Authors who were employees of Ipsen were involved in the design of the study; the analyses and interpretation of data; in the writing of the manuscript, and in the decision to publish the results.