Article

Oral baclofen has long been a mainstay in the management of spasticity. This
review looks at the clinical evidence for the efficacy and safety of oral
baclofen in patients with spasticity of any origin or severity, to determine
whether there is a rationale for the use of intrathecal baclofen. Results suggest
that oral baclofen may be effective in many patients with spasticity, regardless
of the underlying disease or severity, and that it is at least comparable with
other antispasmodic agents. However, adverse effects, such as muscle weakness,
nausea, somnolence and paraesthesia, are common with oral baclofen, affecting
between 25% and 75% of patients, and limiting its usefulness. Intrathecal
baclofen may be an effective alternative as the drug is delivered directly into
the cerebrospinal fluid, thus bypassing the blood-brain barrier and thereby
optimizing the efficacy of baclofen while minimizing drug-related side-effects.
Intrathecal baclofen is a viable option in patients who experience intolerable
side-effects or who fail to respond to the maximum recommended dose of oral
baclofen.

Langue : ANGLAIS