Efficacy and safety of higher doses of botulinum toxin type A NT 201 free from complexing proteins in the upper and lower limb spasticity after stroke

Andrea Santamato, Francesco Panza, Maurizio Ranieri, Vincenza Frisardi, Maria Francesca Micello, Serena Filoni, Francesca Fortunato, Domenico Intiso, Mario Basciani, Giancarlo Logroscino, Pietro Fiore

Research output: Contribution to journalArticle

Abstract

Botulinum toxin type A (BTX-A) represents the gold standard therapy for focal spasticity after stroke, with low prevalence of complications, reversibility, and efficacy in reducing spastic hypertonia. Current guidelines suggest the employment of a dosage up to 600 units (U) of BTX-A to treat spasticity after stroke, to avoid important adverse effects and the development of antibodies against the neurotoxin. In recent years, NT 201, a new BTX-A free of complexing proteins, has been used for treating several movement disorders, showing safety and efficacy in upper limb spasticity. In a prospective, non-randomized, open-label study, we studied the efficacy and safety of higher doses of BTX-A NT 201 (up to 840 U) in 25 consecutive patients with upper and lower limb spasticity after stroke, evaluated at 30 and 90 days after injections. Before and after the treatment, the grade of spasticity, the disability, and spasticity-related pain were extensively measured. After 30 days of follow-up, a great reduction of spasticity and pain with improvement of disability was observed. The effects were still present at 90 days of follow-up. No major adverse events were observed. Higher doses of BTX-A NT 201 appeared to be safe and efficacious in patients with upper and lower limb spasticity after stroke. However, further investigations are needed to determine its reproducibility in larger case series or randomized clinical trials and to observe the absence of antibodies against the neurotoxin also after repeated injections.

Original languageEnglish
Pages (from-to)469-476
Number of pages8
JournalJournal of Neural Transmission
Volume120
Issue number3
DOIs
Publication statusPublished - Mar 2013

Keywords

  • Botulinum toxin type A free of complexing proteins
  • Disability
  • Higher doses
  • NT 201
  • Spasticity
  • Stroke

ASJC Scopus subject areas

  • Biological Psychiatry
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health

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  • Cite this

    Santamato, A., Panza, F., Ranieri, M., Frisardi, V., Micello, M. F., Filoni, S., Fortunato, F., Intiso, D., Basciani, M., Logroscino, G., & Fiore, P. (2013). Efficacy and safety of higher doses of botulinum toxin type A NT 201 free from complexing proteins in the upper and lower limb spasticity after stroke. Journal of Neural Transmission, 120(3), 469-476. https://doi.org/10.1007/s00702-012-0892-x