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

• Published in: Toxins Vol. 14; no. 11; p. 809
• Main Authors: Riberto, Marcelo, Frances, João Amaury, Chueire, Regina, Amorim, Ana Cristina Ferreira Garcia, Xerez, Denise, Chung, Tae Mo, Mercuri, Lucia Helena Costa, Lianza, Sérgio, Rocha, Eduardo Carvalho de Melo, Maisonobe, Pascal, Cuperman-Pohl, Thais, Khan, Patricia
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 20.11.2022; MDPI
• Subjects: abobotulinumtoxinA; Aged; Arm; Botulinum toxin; Botulinum toxin type A; Botulinum Toxins, Type A - therapeutic use; Care and treatment; Caregivers; Confidence intervals; Demographic aspects; Dosage and administration; Female; Humans; Injuries; Male; Middle Aged; Muscle Spasticity - drug therapy; Muscle Spasticity - etiology; Muscles; Pain; Patients; post-stroke; Prospective Studies; Quality of life; Range of motion; Rehabilitation; Shoulder; Shoulder pain; Shoulder Pain - drug therapy; Shoulder Pain - etiology; Spasticity; Stroke; Stroke patients; Subgroups; Testing; therapeutic goal; Toxins; Brazil; therapeutic goal; spasticity; abobotulinumtoxinA; shoulder pain; patients; post-stroke
• ISSN: 2072-6651; 2072-6651
• DOI: 10.3390/toxins14110809

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, = 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 ( = 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.