Variability of Steady State Oral Baclofen Prescribing Practices in Pediatric Patients With Cerebral Palsy

Area of Science:

• Neurology
• Pediatrics
• Pharmacology

Background:

• Cerebral palsy (CP) often necessitates spasticity management with oral baclofen.
• Optimal oral baclofen dosing in pediatric CP patients remains a challenge.
• Current dosing strategies may not fully account for functional classification.

Purpose of the Study:

• To investigate oral baclofen dosing variability in pediatric CP patients.
• To determine the influence of weight and Gross Motor Function Classification System (GMFCS) level on baclofen dosage.
• To assess if traditional weight-based dosing is adequate for this population.

Main Methods:

• Retrospective cross-sectional study of 144 pediatric patients (age 1-21) with CP.
• Analysis of oral baclofen doses at steady state.
• Statistical analysis including one-way ANOVA and post hoc Tukey tests to compare GMFCS levels and weight correlations.

Main Results:

• Mean oral baclofen dose (mg/kg) significantly increased with higher GMFCS levels (P = 0.001).
• Patients with higher ambulatory ability (GMFCS I-II) received lower daily doses than those with lower ability (GMFCS III-V).
• A moderate positive correlation was found between oral baclofen dose and patient weight (r = 0.43, P < 0.0001).

Conclusions:

• Oral baclofen dosing in pediatric CP patients shows significant variability based on GMFCS level.
• GMFCS level is a crucial factor in determining baclofen dosage, potentially more so than weight alone.
• Prescribing oral baclofen for pediatric CP may require a departure from standard weight-based dosing models.