Article

Objective: Treatment strategies for post-stroke spasticity include oral anti-spastic drugs, surgery, physiotherapy and botulinum toxin type A injection. The objective of this study was to compare the cost-effectiveness and outcomes of oral therapy vs. Botulinum toxin type A treatment strategies in patients with flexed wrist/clenched fist spasticity. Methods: Treatment outcome and resource use data were collected from an expert panel experienced in the treatment of post-stroke spasticity. A decision tree model was developed to analyse the data. Results: Thirty-five percent of patients receiving oral therapy showed an improvement in pre-treatment functional targets which would warrant continuation of therapy, compared with 73% and 68% of patients treated with botulinum toxin type A first- and second-line therapy, respectively. Botulinum toxin type A treatment was also more cost-effective than oral therapy with the ''cost-per-successfully-treated month'' being 942 pound, 1387 pound and 1697 pound for botulinum toxin type A first- line, botulinum toxin type A second-line and oral therapy, respectively.
Conclusion: In conclusion, botulinum toxin type A is a cost-effective treatment for post-stroke spasticity.

Langue : ANGLAIS