Department of Rehabilitation, Valduce Villa Beretta Hospital, 23845 Costa Masnaga, Italy.
Department of Neurorehabilitation and Physical Therapy, Vivantes Hospital Spandau, 13585 Berlin, Germany.
Toxins (Basel). 2023 Dec 29;16(1):19. doi: 10.3390/toxins16010019.
A strong correlation has been reported between patient-reported quality of life (QoL) and the investigator-rated Disability Assessment Scale (DAS) in patients with spasticity. The current analysis evaluates the effect of incobotulinumtoxinA on QoL-related outcomes (limb position abnormality, as well as dressing- and hygiene-related disability, measured with the DAS) in adults with upper limb spasticity, using pooled data from six studies. Separate analyses for each DAS domain were performed using data from patients with disabilities for that domain (DAS score ≥1). Results showed that a significantly greater proportion of incobotulinumtoxinA-treated compared with placebo-treated patients achieved a ≥1-point reduction from baseline in each of the DAS domains (improvement) 4 weeks after the first injection. The benefits of incobotulinumtoxinA were observed regardless of the baseline severity of DAS impairment and of the time elapsed since stroke. The effects of incobotulinumtoxinA 4 weeks after injection were maintained or enhanced over multiple injection cycles for all three DAS domains, supporting the use of repeated injection cycles to provide sustained QoL benefit. IncobotulinumtoxinA represents an important treatment option to achieve better QoL-related outcomes for patients with upper limb spasticity, irrespective of the duration of their condition.
已有研究报道,痉挛患者的报告自评生活质量(QoL)与研究者评定的残疾评估量表(DAS)之间存在较强相关性。本分析使用来自 6 项研究的汇总数据,评估了经肌内注射用依库珠单抗毒素 A(incobotulinumtoxinA)对上肢痉挛成人 QoL 相关结局(肢体位置异常,以及 DAS 评估的穿衣和卫生相关残疾)的影响。对于残疾相关的每个 DAS 领域,均进行了针对该领域残疾患者的单独分析(DAS 评分≥1)。结果显示,与安慰剂组相比,首次注射后 4 周时,接受 incobotulinumtoxinA 治疗的患者中,各 DAS 领域(改善)均有更大比例达到与基线相比≥1 分的下降。无论基线 DAS 损害严重程度和卒中发生时间如何,均可观察到 incobotulinumtoxinA 的获益。注射后 4 周,对于所有三个 DAS 领域,incobotulinumtoxinA 的作用得到维持或增强,支持重复注射周期以提供持续的 QoL 获益。对于上肢痉挛患者,无论其病情持续时间如何,incobotulinumtoxinA 均代表一种重要的治疗选择,可实现更好的 QoL 相关结局。