Multiple sclerosis and related disorders · 2026
Differences in efficacy, safety and procedure during a continuous intrathecal baclofen trial to treat severe spasticity in multiple sclerosis compared to other aetiologies.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
van der Gaag Simone Me, Frankema Sander Pg, Wijffels Markus Pjm, Baart Sara J, van der Ploeg Eva S, Huygen Frank Jpm
Аннотация
OBJECTIVE: Spasticity is a common issue following from various conditions and affects daily functioning and quality of life. Intrathecal baclofen (ITB) therapy is offered to patients unresponsive to conventional treatments. Before a permanent ITB-pump is installed, a trial treatment is administered. In our daily practice, we observed that patients with Multiple Sclerosis (MS) experience continuous trials differently compared to patients with other aetiologies. Thus, we aim to compare efficacy, safety, and procedure of continuous ITB-trials between patients with MS and those with other underlying causes of spasticity.
MATERIALS AND METHODS: Adult and ambulatory patients with disabling spasticity, who underwent continuous ITB-trials between January 2014 and January 2022 were included. Data from their medical records were analyzed retrospectively. The study population's characteristics, procedure details, spasticity, (Serious) Adverse Events ((S)AE), patient goals and satisfaction were abstracted and compared between an MS- and a comparator-group.
RESULTS: Records of 54 patients were included; one third had MS. Spasticity improved significantly after the ITB-trial in both groups. Overall, 67% of patients had one or more adverse events. The most common AE was postdural puncture headache (PDPH), which occurred significantly more often in patients with MS than in the comparison group (67%vs. 33%). Severe PDPH was reported in 44% of MS patients compared to 13.9% in the other group. Despite this, MS patients reported greater satisfaction with trial outcomes and were more often seen as suitable for permanent pump implantation.
CONCLUSIONS: Continuous ITB-trials effectively reduce spasticity but adverse events, especially (severe) PDPH, were common and particularly impacted patients with MS. These results raise doubts about whether continuous ITB-trials should be the first choice for ambulatory MS patients.
MATERIALS AND METHODS: Adult and ambulatory patients with disabling spasticity, who underwent continuous ITB-trials between January 2014 and January 2022 were included. Data from their medical records were analyzed retrospectively. The study population's characteristics, procedure details, spasticity, (Serious) Adverse Events ((S)AE), patient goals and satisfaction were abstracted and compared between an MS- and a comparator-group.
RESULTS: Records of 54 patients were included; one third had MS. Spasticity improved significantly after the ITB-trial in both groups. Overall, 67% of patients had one or more adverse events. The most common AE was postdural puncture headache (PDPH), which occurred significantly more often in patients with MS than in the comparison group (67%vs. 33%). Severe PDPH was reported in 44% of MS patients compared to 13.9% in the other group. Despite this, MS patients reported greater satisfaction with trial outcomes and were more often seen as suitable for permanent pump implantation.
CONCLUSIONS: Continuous ITB-trials effectively reduce spasticity but adverse events, especially (severe) PDPH, were common and particularly impacted patients with MS. These results raise doubts about whether continuous ITB-trials should be the first choice for ambulatory MS patients.