Otero-Romero, S;
Sastre-Garriga, J;
Comi, G;
Hartung, HP;
Soelberg Sørensen, P;
Thompson, AJ;
Vermersch, P;
... Montalban, X; + view all
(2016)
Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper.
Multiple Sclerosis Journal
, 22
(11)
pp. 1386-1396.
10.1177/1352458516643600.
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Abstract
BACKGROUND AND OBJECTIVES: Treatment of spasticity poses a major challenge given the complex clinical presentation and variable efficacy and safety profiles of available drugs. We present a systematic review of the pharmacological treatment of spasticity in multiple sclerosis (MS) patients. METHODS: Controlled trials and observational studies were identified. Scientific evidence was evaluated according to pre-specified levels of certainty. RESULTS: The evidence supports the use of baclofen, tizanidine and gabapentin as first-line options. Diazepam or dantrolene could be considered if no clinical improvement is seen with the previous drugs. Nabiximols has a positive effect when used as add-on therapy in patients with poor response and/or tolerance to first-line oral treatments. Despite limited evidence, intrathecal baclofen and intrathecal phenol show a positive effect in severe spasticity and suboptimal response to oral drugs. CONCLUSION: The available studies on spasticity treatment offer some insight to guide clinical practice but are of variable methodological quality. Large, well-designed trials are needed to confirm the effectiveness of antispasticity agents and to produce evidence-based treatment algorithms.
| Type: | Article |
|---|---|
| Title: | Pharmacological management of spasticity in multiple sclerosis: Systematic review and consensus paper |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1177/1352458516643600 |
| Publisher version: | http://dx.doi.org/10.1177/1352458516643600 |
| Language: | English |
| Additional information: | Copyright © The Author(s), 2016. |
| Keywords: | Multiple sclerosis, pharmacological treatment, review, spasticity |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1496196 |
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