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1334 - Moderate-to-severe upper limb spasticity patterns in the elderly are improved following treatment with incobotulinumtoxinA: a pooled analysis

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Co-Author(s)

Michael C. C. Munin, MD

Attending Physician
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania, United States
AC

Alexandre Camões-Barbosa, MD

Physician
Unidade Local de Saúde de S. José
Lisbon, Lisboa, Portugal
CC

Carlos Cordero-García, MD

Physician
Juan Ramón Jiménez University Hospital
Huelva, Andalucia, Spain
MA

Michael Althaus, MD

Principle Medical Expert
Merz Therapeutics GmbH
Frankfurt, Hessen, Germany
GC

Georg Comes, n/a

Senior Biostatistician
Merz Therapeutics GmbH
Frankfurt, Hessen, Germany

Presenting Author(s)

MV

Matteo Vacchelli, MD

Lead Medical Expert
Merz Therapeutics GmbH
Frankfurt, Hessen, Germany

Co-Author(s)

CW

Carmen Walter, PhD

Medical Expert
Merz Therapeutics GmbH
Frankfurt, Hessen, Germany
Joerg Wissel, MD

Consultant in Neurology and Rehabilitation
Neurology and Psychosomatic at Wittenbergplatz, Out-patient Clinic
Berlin, Berlin, Germany

Objectives: To compare upper limb spasticity (ULS) severity changes from baseline in spastic patterns at 4 and 12 weeks post-injection of incobotulinumtoxinA (incoA) versus placebo in elderly patients.

Design: Pooled data were extracted from six prospective studies of incoA in the treatment of upper or upper and lower limb spasticity. In all studies, patients could receive incoA at a total body dose of 400 U. A subgroup of patients aged ≥65 years with moderate-to-severe ULS at baseline manifesting as a variety of spastic patterns was analysed. Severity was determined by Ashworth Scale (AS); moderate = not severe and AS ≥3 in at least 2 joints assessed; severe: AS = 4 in at least 2 joints assessed. Least squares mean (LSM) change from baseline differences between incoA and placebo in AS score of different spasticity patterns, at 4- and 12-weeks post injection were calculated. “As observed” data were analysed using ANCOVA. Safety was evaluated throughout the 12-week period.

Results: Mean (SD) age of the 207 patients was 70.0 (4.1) years; 13.5% were aged ≥75 years, 63.3% were male, mean (SD) time from spasticity diagnosis was 5.3 (5.3) years; 85.5% had moderate and 14.5% had severe ULS. The aetiology of spasticity was stroke in >99% of patients. For all ULS patterns with sufficient power for statistical analysis, incoA produced greater improvement in AS score compared with placebo at week 4 (p< 0.05); for most of these patterns, the difference remained significant at week 12 (p< 0.05). IncoA was generally well tolerated, with few differences reported between patients aged 65 to < 75 years and ≥75 years.

Conclusions: In this analysis of elderly patients with moderate-to-severe ULS, incoA was well tolerated and improved upper limb muscle tone, thereby reducing debilitating ULS that was predominantly due to stroke.