Spasticity in multiple sclerosis (MS) patients can beย easedย throughย a combinationย of botulinum toxin type A (BoNT-A) injections and rehabilitation. However, caregiver support is required toย keep patients on thisย treatment, according to results of a retrospective analysis.

The study, โ€œDeterminants of botulinum toxin discontinuation in multiple sclerosis: a retrospective studyโ€ was published in the journal Neurologicalย Sciences.

Spasticity, a muscle control disorder characterized by tight or stiff muscles, is a major MS symptom. The condition isย significantly detrimental toย patientsโ€™ quality of life, affecting their general mobility and balance.

Several oral anti-spasticityย drugs are available. However, โ€œtreatment of spasticity in MS is frequently challenging because of the complex clinical picture and the undesired effects associated with oral therapy, such as fatigue, dizziness, and hypotension,โ€ the researchersย wrote.

Previous studies show that BoNT-A, a toxin that blocks nerve activity in muscles, is an effective therapy for the management of MS-related spasticity.

The long-term effectiveness and persistence of BoNT-A use in patients withย MS-related spasticity, however, remains poorly investigated.

The research team in Italy proposed โ€œto investigate the long-term persistence to treatment with BoNT-A for MS-related spasticity and the determinants of BoNT-A discontinuation in daily clinical setting.โ€

Itย performed a retrospective analysis of data on MS patients who had undergone BoNT-A injections and were routinely followed in the clinic (at least two visits per year). Before starting the injections, patients were clinically evaluated, including anย assessment of their level of spasticity (using the Modified Ashworth Scale or MAS), and degree of disability (through the Expanded Disability Status Scale or EDSS).

In total, the researchersย reviewed data from 185 patients, out of which 121 were considered in their final analysis.

Theyย observed that, at the end ofย the follow-up period (12ย years), 44% of the patients in the analysis were still being treated with BoNT-A, but 56% had discontinued treatment.