Title:Clinical Onset of Action of Incobotulinum Toxin A Preparation
Volume: 22
Issue: 6
Author(s): Riccardo Marvulli*, Maurizio Ranieri, Laura Belinda Rizzo, Francesco Marra, Giancarlo Ianieri and Marisa Megna
Affiliation:
- Department of Basic Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, G. Cesare Place 11,
70125, Bari, Italy
Keywords:
Spasticity, botulinum toxin type A, stroke, electroneurography, myometric measurement, physiotherapy
Abstract:
Background: Many studies in vitro compared the onset of action, maximum efficacy, and
duration of botulinum toxin type A (BoNT/A) preparations.
Objective: In this study, we analyzed the onset of action of BoNT/A preparation free of complexing
proteins in patients with upper limb spasticity post stroke up to 30 days after treatment.
Methods: 75 patients affected by Biceps Brachii spasticity were enrolled. Outcome measures were instrumental
muscle tone modification (myometric measurement), improvement of Modified Ashworth
Scale (MAS), improvement of elbow’s passive extension, and improvement of compound muscle action
potential (cMAP) evaluated by electroneurography. We analyzed data at t0 (pre-injection), t1
(1 day after), t2 (7 days after), t3 (14 days after), and t4 (30 days after).
Results: All measurements decreased at t2, t3, and t4 with initial improvement at t2 and maximum
improvement at t4; no statistical difference at t1 was found.
Conclusion: This study demonstrated the onset of Incobotulinumtoxin A efficacy started after 7 days;
this rapid action and efficacy of BoNT/A preparation could improve an intensive rehabilitation program
after some days post-injection. Early clinical onset of action could be by the absence of complexing
proteins in the preparation.
