Benefits of Incobotulinumtoxin A in Pain, Spasticity and Functionality-A 5 Years Review

Pain is a major contributor to functional impairment in neurological patients. Botulinum toxin type A (BT-A) is well-established for focal spasticity and has shown some benefits in pain reduction. Long-term data from large cohorts remain limited.

This retrospective study (2017-2022) analyzed 20 variables from spastic patients treated with Incobotulinumtoxin A (INCO) for pain and spasticity. Functional analysis was classified into 5 major domains: Pain, Spasticity spectrum, Mobility, Activities of daily living, and Gait.

A total of 1575 records from 67 patients were collected. The mean age was 57.7 years, mostly female (n = 35), and stroke was the leading etiology (n = 40). The most typical patterns were wrist flexion (80%) and ankle flexion (94.9%). It was injected with 50 to 400 units of INCO, targeting an average of 3.47 upper-limb and 2.34 lower-limb muscles per session. Functional improvement was observed across all domains (GAS change 27.4), with the greatest effects in pain (GAS change 26.9; 5.16 VAS reduction).

The findings, derived from one of the largest datasets, support that INCO, and probably BT-A, should be indicated for the pain of spastic patients, regardless of etiology.

Promising functionality outcomes, especially in this group, warrant further, more comprehensive studies.