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Related Concept Videos

Directly Acting Muscle Relaxants: Dantrolene and Botulinum Toxin01:26

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Directly acting muscle relaxants like dantrolene and botulinum toxin (BoNT) have distinct mechanisms and applications. Dantrolene, a hydantoin derivative, acts on the ryanodine receptor (RYR1) in skeletal muscle cells. RYR1 are calcium channels present at the sarcoplasmic reticulum membrane. In response to excitation, they release calcium ions from the sarcoplasmic reticulum to the cytosol. Calcium promotes actin-myosin-mediated contraction of muscles.
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Skeletal Muscle Relaxants: Therapeutic Uses01:31

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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Spasmolytic Agents: Chemical Classification01:29

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Classification of Skeletal Muscle Relaxants01:28

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Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
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Skeletal muscle relaxants can target the central nervous system [CNS] to reduce muscle tension or act directly at the neuromuscular junction to induce temporary paralysis. These two classes of muscle relaxants are called centrally acting muscle relaxants and peripherally acting muscle relaxants. They differ in their action, mechanism, administration route, and clinical uses.
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Centrally Acting Muscle Relaxants: Therapeutic Uses01:24

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Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
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Real-World Switch Rates, Treatment Patterns, and Healthcare Costs Among Patients With Spasticity Treated With

Annaliza Dominguez1, Darshini Shah2, Ning Cheng3

  • 1AbbVie Inc., North Chicago, IL, USA. annaliza.dominguez@abbvie.com.

Advances in Therapy
|March 30, 2026
PubMed
Summary

OnabotulinumtoxinA initiators showed lower switch rates and reduced fracture-related costs compared to other botulinum toxin type A treatments for spasticity. Real-world data reveals distinct treatment patterns and economic impacts.

Keywords:
AbobotulinumtoxinABotulinum toxinsHealthcare costsIncobotulinumtoxinAMuscle spasticityOnabotulinumtoxinARetrospective claims analysisTreatment patternsTreatment switching

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Area of Science:

  • Neurology
  • Pharmacology
  • Health Economics

Background:

  • Botulinum toxin type A is a standard treatment for adult spasticity.
  • Limited comparative real-world data exists for different botulinum toxin type A therapies.
  • This study addresses the need for comparative data on treatment patterns and costs.

Purpose of the Study:

  • Compare switch rates among patients initiating onabotulinumtoxinA, abobotulinumtoxinA, or incobotulinumtoxinA.
  • Evaluate healthcare resource utilization (HCRU) across these treatments.
  • Analyze and compare treatment costs associated with each botulinum toxin type A.

Main Methods:

  • Retrospective cohort study using de-identified Clinformatics® Data Mart Database (2017-2023).
  • Included adult patients with spasticity receiving botulinum toxin type A with ≥12 months enrollment pre- and post-initiation.
  • Outcomes measured: switch rates, all-cause and condition-specific HCRU, and costs.

Main Results:

  • OnabotulinumtoxinA was the most common initiation (88.7%).
  • Switch rates at 12 months were lowest for onabotulinumtoxinA (1.4%) versus abobotulinumtoxinA (4.0%) and incobotulinumtoxinA (10.6%).
  • OnabotulinumtoxinA initiators had lower all-cause medical and fracture-related costs; HCRU was comparable.

Conclusions:

  • OnabotulinumtoxinA initiation is associated with lower switch rates compared to incobotulinumtoxinA and abobotulinumtoxinA.
  • Total costs were similar across treatments, with onabotulinumtoxinA showing advantages in all-cause medical and fracture-related expenditures.
  • Findings provide valuable real-world insights into the comparative effectiveness and economic impact of botulinum toxin type A therapies for spasticity.