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Study to Assess the Effectiveness of AboBoNT-A Injections for Adult Lower Limb Spasticity in a Real Life Cohort

Completed
Conditions
Adult Lower Limb Spasticity
Registration Number
NCT04050527
Lead Sponsor
Ipsen
Brief Summary

The purpose of the protocol is to assess the longitudinal attainment of person-centered and function related goals of patients who receive AbobotulinumtoxinA (aboBoNT-A) injections for adult lower limb spasticity over a period of 16 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
438
Inclusion Criteria
  • Adult male and female subjects ≥18 years of age
  • Primary diagnosis with unilateral adult lower limb nonprogressive spasticity.
  • Subject able to take more than five steps with or without assistance.
  • Decision to treat the lower limb with aboBoNT-A by the care provider made prior to, and independently from, the decision to enroll the subject in the observational study as per country label.
  • Previously untreated with BoNT-A (i.e. naïve to BoNT-A), or previously treated with a BoNT-A (i.e. non-naïve to BoNT-A). For those who were previously treated with BoNTA, they should have responded to BoNT-A treatment and at least 12 weeks should have elapsed from prior injection.
  • Signed informed consent prior to participation in the study.
Exclusion Criteria
  • Prior history of nonresponsiveness to BoNT-A therapy
  • Previous treatment with BoNT-A of less than 12 weeks prior to enrolment in study.
  • Current participation in any other clinical study or have participated within the 12 weeks prior to the Inclusion visit (Visit 1) of this study.
  • Severe limitations in passive range of motion/contractures in the affected limb (MAS=4 in at least one of the joints in the lower limb).
  • Limb surgery or intrathecal baclofen therapy placement for spasticity within 3 months.
  • Nonambulatory subject.
  • Pregnant and lactating women.
  • Progressive neurological conditions or diagnosis of cerebral palsy.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Subject centred Goal Attainment Scaling Leg T score (GASleg T)16 months

Mean individual GASleg T score. Goal attainment for each goal will be recorded clinically on a 5-point verbal rating scale (range -2 to +2) and goal scores combined to give an aggregated T score using a standard formula (GASleg T score). Range meaning is -2 = much less than expected and +2 = much more than expected.

The subject and/or caregiver to identify the main goal areas and establish agreed person centred and function related goals guided by GASleg (usually one primary and up to two secondary goals) at each visit. Goal attainment will be evaluated at the routine follow up visit.

Goals will be redefined and/or newly set at each injection visit or as per routine practice if further injections are not given. Goals will be SMART \[Specific, measurable, attainable, relevant, and time-based\]

Secondary Outcome Measures
NameTimeMethod
Muscle tone16 months

Muscle tone will be evaluated using the Modified Ashworth Scale (MAS) /Tardieu Scale according to clinical practice. The MAS is a six point scale (with available scores of 0, 1, 1+, 2, 3 and 4) reporting changes in muscle tone during muscle flexion or extension. Tardieu scale quantifies muscle spasticity by assessing the response of the muscle to stretch applied at specified velocities. It can therefore broadly differentiate between the two key factors explaining resistance to passive stretch, namely contracture (non-neural factors) and spasticity (neural factors).

Assess correlations of subject centered goals16 months

Correlations of subject centred goals and related standardised rating scales will be assessed using GASleg and standardised outcome measures selected according to the goals for treatment.

Total dose injected per cycle16 months
Report dose per muscle16 months
Severity of different aspects of impairment16 months

Severity of different aspects of impairment in subjects with neurological injury will be evaluated using the Lower Limb Spasticity adapted Neurological Impairment Scale. (LLS-NIS) Higher LLS-NIS scores indicate more severe impairment (LLS-NIS). Higher LLS-NIS scores indicate more severe impairment.

Report muscles injected16 months
Evolution of Quality of Life16 months

Assess the evolution of QoL at each visit based on the EQ-5D-5L and the QoL element of LegA. This is a descriptive scale that covers 5 dimensions: mobility, self-care, usual activities,pain/discomfort and anxiety/depression. the scale consist of 5 levels, where level one corresponds to "no problems" and level 5 corresponds to "extreme problem".

Trial Locations

Locations (51)

Wake Forest University Baptist Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

Riverhills Healthcare

🇺🇸

Cincinnati, Ohio, United States

OrthoNeuro

🇺🇸

Columbus, Ohio, United States

Good Shepherd Rehabilitation Hospital - Neurology

🇺🇸

Allentown, Pennsylvania, United States

University of Texas Southwestern

🇺🇸

Dallas, Texas, United States

Beaumont Hospital, Grosse Pointe - Neurology

🇺🇸

Grosse Pointe, Michigan, United States

Hospital de Base de São José do Rio Preto at Centro Integrado de Pesquisa (CIP) - Neurology

🇧🇷

São José Do Rio Preto, Brazil

McGill University Health Center

🇨🇦

Montréal, Canada

Glenrose Rehabilitation Hospital

🇨🇦

Edmonton, Canada

Centre Hospitalier Regional Universitaire (CHRU) de Lille - Hopital Pierre Swynghedauw - Neurology

🇫🇷

Lille, France

Neurologische Klinik und Poliklinik

🇩🇪

Würzburg, Germany

SP ZOZ Szpital Uniwersytecki w Krakowie

🇵🇱

Kraków, Poland

Wojewódzki Szpital Specjalistyczny we Wrocławiu

🇵🇱

Wroclaw, Poland

Federal State Budgetary Institution "All-Russian Center for Emergency Medicine and Medical Radiology named after A.M. Nikiforov" of the EMERCOM of Russia

🇷🇺

Saint-Petersburg, Russian Federation

MedStar National Rehabilitation Hospital

🇺🇸

Washington, District of Columbia, United States

Neurology Center of NE,PC - Neurology

🇺🇸

Foxboro, Massachusetts, United States

Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto (HCFMRP) - Neurology

🇧🇷

Ribeirão Preto, Brazil

Università Degli studi della Campania - Luigi Vanvitelli - Neurologica

🇮🇹

Napoli, Italy

PO Villa Sofia, AO Ospedali Riuniti Villa Sofia-Cervello

🇮🇹

Palermo, Italy

SAHI Interregional Clinical Diagnostic Center

🇷🇺

Kazan, Russian Federation

CHU - Hôpital Pellegrin - Neurologie

🇫🇷

Bordeau, France

Mazowiecki Szpital Brodnowski w Warszawie Sp. z o.o. Brodnowskie Centrum Kliniczne Poliklinika Brodnowskiego Centrum Klinicznego

🇵🇱

Warsaw, Poland

Pavlov First Saint-Petersburg State Medical University - Neurology

🇷🇺

Saint-Petersburg, Russian Federation

The University of Utah School of Medicine

🇺🇸

Salt Lake City, Utah, United States

CHU RAYMOND POINCARE - Neurology

🇫🇷

Garches, France

Pole Saint Helier

🇫🇷

Rennes, France

Universitätsklinikum Erlangen

🇩🇪

Erlangen, Germany

Istituto Scientifico di Riabilitazione di Veruno, Fondazione

🇮🇹

Novara, Italy

Instytut Psychiatrii i Neurologii

🇵🇱

Warsaw, Poland

Regional state budget health institution "City Hospital № 5"

🇷🇺

Barnaul, Russian Federation

Höpital Sainte-Marie - Neurology

🇫🇷

Paris, France

Neurologie und Psychosomatik am Wittenbergplatz

🇩🇪

Berlin, Germany

AO S.Camillo-Forlanini

🇮🇹

Roma, Italy

Centre Hospitalier Universitaire De Reims - Hopital Maison B

🇫🇷

Reims, France

Medizinische Hochschule Hannover - Neurology Neurologische Poliklinik

🇩🇪

Hannover, Germany

Universitätsklinikum/Neurologie

🇩🇪

Luebeck, Germany

Universita degli Studi di Verona - Centro di Ricerca in Riabilitazione Neuromotoria e Cognitiva (CRRNC) - Neurology

🇮🇹

Verona, Italy

FGBOU VO "Ural state medical university"

🇷🇺

Ekaterinburg, Russian Federation

Bekhterev National Research Medical Center for Psychiatry

🇷🇺

Saint Petersburg, Russian Federation

National Medical Research Treatment and Rehabilitation Center of the Ministry of Health of Russia

🇷🇺

Moscow, Russian Federation

Rancho Los Amigos National Rehabilitation Center (RLANRC) - Neurology

🇺🇸

Downey, California, United States

Kansas City Bone and Joint Clinic, P.A. (KCBJ) - Overland Pa

🇺🇸

Leawood, Kansas, United States

Dayton Center for Neurological Disorders

🇺🇸

Centerville, Ohio, United States

Yeshiva University - Albert Einstein College of Medicine - Montefiore Medical Center (MMC) - Neurology

🇺🇸

Bronx, New York, United States

MossRehab - Einstein Medical Center

🇺🇸

Elkins Park, Pennsylvania, United States

Rehabilitation Associates - Neurology

🇺🇸

Paoli, Pennsylvania, United States

Medical College of Wisconsin - Froedtert Hospital

🇺🇸

Milwaukee, Wisconsin, United States

Princess Alexandra Hospital

🇦🇺

Ipswich, Australia

Royal Prince Alfred Hospital

🇦🇺

Rozelle, Australia

River Valley Health - Stan Cassidy Foundation - Stan Cassidy

🇨🇦

Fredericton, Canada

Wojew. Wielospecjalistyczne Centrum Onkologii i Traumatologii im.M.Kopernika w Lodzi

🇵🇱

Łódź, Poland

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