Abstract
Background and Aim: Botulinum toxin type A is considered to be an effective antispasmodic in recent years.
We assess the effectiveness of botulinum toxin type A for the treatment of poststroke
spasticity in the upper extremity using a meta-analysis. Methods: We searched several databases including PubMed, Web of Science, Embase, and Cochrane
database for relevant studies, up until October 2017. All randomized controlled trials
of botulinum toxin type A treat poststroke upper limb spasticity published were included.
The primary outcome measure was modified ashworth score at the elbow, finger and wrist,
pain score, and barthel index. Results: Ten randomized controlled trials were identified and reported sufficient data for
inclusion in the pooled analysis (n = 950). The results of modified ashworth score
at different joints, pain score, barthel index showed no difference was found in the
effectiveness of botulinum toxin type A compared with placebo in the treatment of
the upper limb spasticity after stroke. But modified ashworth score at the elbow was
improver in Dysport subgroups (standardized mean difference [SMD] = −.39, 95%CI = −.67
to −.10, P = .008) compared with Botox subgroups (SMD = .08, 95%CI = −.68 to .83, P = .84). Conclusions: The meta-analysis of these studies showed that the overall effectiveness of botulinum
toxin type A does not seem to differ from placebo for poststroke Patients. But the
meta-analysis yielded a favorable effect of Dysport compared with placebo based on
4 trials.
Key Words
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Article info
Publication history
Published online: April 15, 2020
Accepted:
January 16,
2020
Received in revised form:
December 21,
2019
Received:
July 17,
2019
Footnotes
Shi Yu Jia and Yang Liu contributed equally to this work.
Funding: This study was supported by Chongqing Health and Family Planning Commission (no. 2017MSXM023 and no. 2017ZBXM046).
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104682
Copyright
© 2020 Published by Elsevier Inc.
