300 Section - Moderate-to-severe upper limb spasticity patterns in the elderly are improved following treatment with incobotulinumtoxinA: a pooled analysis

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Corresponding Author/Autor a quien dirigir la corr(s)

Michael C. Munin, MD

Doctor
University of Pittsburgh
Pittsburgh, Pennsylvania, United States

Co-Author/Coautor(s)

AC

Alexandre Camões-Barbosa, MD

Doctor
Unidade Local de Saúde de S. José
Lisbon, Lisboa, Portugal
CC

Carlos Cordero-García, PhD

Professor of Physical and Rehabilitation Medicine
Juan Ramon University Hospital
Huelva, Andalucia, Spain
AB

Alessio Baricich, PhD

Full Professor in Physical and Rehabilitation Medicine; Head of Rehabilitation Unit
IRCCS Humanitas Research Hospital
Milan, Lombardia, Italy
MA

Michael Althaus, MD

Retired
Merz Therapeutics GmbH
Frankfurt, Hessen, Germany
GC

Georg Comes, n/a

Senior Biostatistician
Merz Therapeutics GmbH
Frankfurt, Hessen, Germany

Presenting Author/Autor expositor(s)

MV

Matteo Vacchelli, MD

Global Medical Lead – Global Medical Affairs
Merz Therapeutics GmbH
Frankfurt, Hessen, Germany

Co-Author/Coautor(s)

CW

Carmen Walter, PhD

Medical Expert
Merz Therapeutics GmbH
Frankfurt, Hessen, Germany
Jörg Wissel, MD

Professor
Merz Therapeutics GmbH
Potsdam, Brandenburg, Germany

Objectives : More than 12.2 million new strokes occur each year Spasticity is common after stroke with aged care facility residents reporting that 70% with a history of stroke develop upper limb spasticity (ULS). 76% of those with spasticity related needs go unmet. We compared ULS severity changes from baseline at 4 and 12 weeks’ post-injection of incobotulinumtoxinA (incoA) versus placebo (PBO) in elderly patients with moderate-to-severe ULS.

Design: Pooled data were extracted from six studies of incoA in the treatment of upper or upper and lower limb muscle spasticity Patients aged ≥65 years with moderate-to-severe ULS at baseline could receive incoA (most common total body dose: 400U). Severity was determined by the Ashworth Scale (AS); moderate=not severe and AS ≥3 in ≥2 joints assessed; severe: AS=4 in ≥2 joints assessed. Least squares mean (LSM) change from baseline differences between incoA and PBO in AS score of different spasticity patterns, at 4- and 12-weeks post-injection were calculated (one of the pooled studies used modified AS scores). “As observed” data were analysed using analysis of covariance (ANCOVA). Safety was also evaluated throughout.

Results: Mean (standard deviation (SD)) age of the 207 included patients was 70.0 (4.1) years; 13.5% were aged ≥75 years, 63.3% were male, mean (SD) time from spasticity diagnosis was 5.3 (5.3) years and 85.5% had moderate and 14.5% had severe ULS. The etiology of spasticity was stroke in >99% of patients. For all ULS patterns with sufficient power for statistical analysis, incoA produced greater improvement in AS score compared with PBO at week 4 (p< 0.05) and week 12; (p< 0.05), IncoA was generally well tolerated

Conclusion:

In this analysis of elderly patients with moderate-to-severe ULS, incoA was well tolerated and improved upper limb muscle tone, reducing debilitating ULS that was predominantly due to stroke.