Leevi
ALStuttu:n jäsen
Botuliini A:n ("Botox-A") käyttämisestä ALS-potilaiden spastisuuden hoidossa on julkaistu uusi tutkimus, potilailla joilla on ylämotoneuroni-dominantti taudin tyyppi (UMN-D ALS) tai PLS-tauti (primääri lateraaliskleroosi).
http://www.ncbi.nlm.nih.gov/pubmed/27383643
Yhteenvedossa esitetty johtopäätös vapaasti suomennettuna: "Kaikilla botoxia saaneilla kliininen lopputulema oli parantunut ja kaikki paitsi yksi kertoivat subjektiivisesti spastisuusoireiden parantumisesta/vähenemisestä. Lisäksi, mediaani 16 kuukauden seurannan ja kolmen botox-pistoksen jälkeen Botox-A:n vaikutus säilyi ilman sivuvaikutuksia. Tämä tutkimus tarjoaa luokan IV todisteita että Botox-A on turvallinen, ja voi olla hyödyllinen lyhyellä ja pitkällä aikavälillä ALS-potilaiden alaryhmässä joilla on keskivaikeaa - vaikeaa spastisuutta."
J Neurol. 2016 Jul 6. [Epub ahead of print]
Safety and efficacy of botulinum toxin A for the treatment of spasticity in amyotrophic lateral sclerosis: results of a pilot study.
Vázquez-Costa JF1,2,3, Máñez I4, Alabajos A4, Guevara Salazar M4, Roda C4, Sevilla T5,6,7,8.
Abstract
Spasticity can be a very disabling problem in some amyotrophic lateral sclerosis (ALS) phenotypes, such as upper motor neuron-dominant ALS (UMN-D ALS) and primary lateral sclerosis (PLS). Our aim is to describe the safety and efficacy of botulinum toxin A (BoTox-A) for improving gait in those ALS phenotypes. UMN-D ALS and PLS outpatients experiencing gait disturbances, secondary to moderate-to-severe spasticity despite optimized oral medication, were offered BoTox-A treatment. Stretching exercises were indicated to complement BoTox-A effect, and ankle-foot orthotics were prescribed when appropriate. Tolerance (muscle strength, disease progression rate) and efficacy (10-m walk test) were measured at baseline and after treatment. Eight out of 122 ALS outpatients were offered BoTox-A treatment. One declined and the other seven were administered BoTox-A in the lower limbs, every 5-8 months. All of them experienced improvement in the clinical outcome and all but one referred subjective improvement. Moreover, after a median follow-up of 16 months and three injections, BoTox-A effect was maintained with no adverse events. This study provides class IV evidence that BoTox-A is safe , and could be beneficial in the short term and long term in a subset of ALS patients with moderate-to-severe spasticity.
http://www.ncbi.nlm.nih.gov/pubmed/27383643
Yhteenvedossa esitetty johtopäätös vapaasti suomennettuna: "Kaikilla botoxia saaneilla kliininen lopputulema oli parantunut ja kaikki paitsi yksi kertoivat subjektiivisesti spastisuusoireiden parantumisesta/vähenemisestä. Lisäksi, mediaani 16 kuukauden seurannan ja kolmen botox-pistoksen jälkeen Botox-A:n vaikutus säilyi ilman sivuvaikutuksia. Tämä tutkimus tarjoaa luokan IV todisteita että Botox-A on turvallinen, ja voi olla hyödyllinen lyhyellä ja pitkällä aikavälillä ALS-potilaiden alaryhmässä joilla on keskivaikeaa - vaikeaa spastisuutta."
J Neurol. 2016 Jul 6. [Epub ahead of print]
Safety and efficacy of botulinum toxin A for the treatment of spasticity in amyotrophic lateral sclerosis: results of a pilot study.
Vázquez-Costa JF1,2,3, Máñez I4, Alabajos A4, Guevara Salazar M4, Roda C4, Sevilla T5,6,7,8.
Abstract
Spasticity can be a very disabling problem in some amyotrophic lateral sclerosis (ALS) phenotypes, such as upper motor neuron-dominant ALS (UMN-D ALS) and primary lateral sclerosis (PLS). Our aim is to describe the safety and efficacy of botulinum toxin A (BoTox-A) for improving gait in those ALS phenotypes. UMN-D ALS and PLS outpatients experiencing gait disturbances, secondary to moderate-to-severe spasticity despite optimized oral medication, were offered BoTox-A treatment. Stretching exercises were indicated to complement BoTox-A effect, and ankle-foot orthotics were prescribed when appropriate. Tolerance (muscle strength, disease progression rate) and efficacy (10-m walk test) were measured at baseline and after treatment. Eight out of 122 ALS outpatients were offered BoTox-A treatment. One declined and the other seven were administered BoTox-A in the lower limbs, every 5-8 months. All of them experienced improvement in the clinical outcome and all but one referred subjective improvement. Moreover, after a median follow-up of 16 months and three injections, BoTox-A effect was maintained with no adverse events. This study provides class IV evidence that BoTox-A is safe , and could be beneficial in the short term and long term in a subset of ALS patients with moderate-to-severe spasticity.
