- •A phase III clinical trial was performed for a novel botulinum toxin A, NABOTA, on post-stroke upper limb spasticity.
- •NABOTA demonstrated non-inferiority on efficacy and safety compared to onabotulinum toxin A (Botox).
- •NABOTA may serve as an alternative for treatment of post-stroke upper limb spasticity using botulinum toxin A.
Botulinum toxin A is widely used in the clinics to reduce spasticity and improve upper limb function for post-stroke patients. Efficacy and safety of a new botulinum toxin type A, NABOTA (DWP450) in post-stroke upper limb spasticity was evaluated in comparison with Botox (onabotulinum toxin A). A total of 197 patients with post-stroke upper limb spasticity were included in this study and randomly assigned to NABOTA group (n = 99) or Botox group (n = 98). Wrist flexors with modified Ashworth Scale (MAS) grade 2 or greater, and elbow flexors, thumb flexors and finger flexors with MAS 1 or greater were injected with either drug. The primary outcome was the change of wrist flexor MAS between baseline and 4 weeks post-injection. MAS of each injected muscle, Disability Assessment Scale (DAS), and Caregiver Burden Scale were also assessed at baseline and 4, 8, and 12 weeks after the injection. Global Assessment Scale (GAS) was evaluated on the last visit at 12 weeks. The change of MAS for wrist flexor between baseline and 4 weeks post-injection was −1.44 ± 0.72 in the NABOTA group and −1.46 ± 0.77 in the Botox group. The difference of change between both groups was 0.0129 (95% confidence interval −0.2062–0.2319), within the non-inferiority margin of 0.45. Both groups showed significant improvements regarding MAS of all injected muscles, DAS, and Caregiver Burden Scale at all follow-up periods. There were no significant differences in all secondary outcome measures between the two groups. NABOTA demonstrated non-inferior efficacy and safety for improving upper limb spasticity in stroke patients compared to Botox.
Abbreviations:MAS (modified Ashworth Scale), DAS (Disability Assessment Scale), GAS (Global Assessment Scale), FAS (full analysis set), PPS (per protocol set)
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Published online: July 21, 2015
Accepted: July 18, 2015
Received in revised form: July 17, 2015
Received: May 9, 2015
☆Clinical Trial Registration — URL://www.clinicaltrials.gov. Unique identifier: NCT02184988.
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.