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Final Program


Final Congress Guide

Clinical Sciences/Health Conditions

300 Section - Improvement in upper limb spasticity patterns in the elderly following treatment with incobotulinumtoxinA: a pooled analysis

Tuesday, May 19, 2026
6:00 PM - 7:30 PM PT
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 developed upper limb spasticity (ULS). Spasticity is often undertreated and older patients are  underrepresented in clinical trials,. We compared changes from baseline in ULS severity in different spastic patterns at 4 weeks and 12 weeks post-injection of incobotulinumtoxinA (incoA) versus placebo (PBO) in elderly patients.

Design: Data from 7 prospective, studies of incoA in the treatment of upper or upper and lower limb muscle spasticity were pooled. In all studies, patients could receive incoA at a total body dose of 400 U. This analysis focuses on patients aged ≥65 years with ULS; the least squares mean (LSM) change from baseline differences between incoA and PBO in Ashworth Scale (AS) score at 4- and 12-weeks post injection were calculated (one of the pooled studies used modified AS scores). “As observed” data were analyzed using analysis of covariance (ANCOVA). Safety was also evaluated throughout.

Results: Mean (SD) age of the 267 included patients was 70.3 (4.2) years; 15.0% were aged ≥75 years, 62.6% were male and mean (SD) time from spasticity diagnosis was 5.0 (5.4) years. The aetiology 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, with no treatment-related serious adverse events or deaths reported

Conclusion:

This is the largest cohort of older patients to provide data regarding the use of incoA in ULS. Results show that incoA was well tolerated and upper limb muscle tone was improved. ULS predominantly due to stroke was reduced.