Article

This study is aimed at providing a quantitative evaluation on
different therapies of spasticity caused by multiple sclerosis. DATA SOURCES:
PubMed and Embase database. REVIEW METHODS:
We searched for randomized controlled
trials that met the requirements. Percentages of improved patients' spasticity
scale, mild adverse effect and severe adverse effect were extracted as outcomes.
The forest plots accompanied with surface under the cumulative ranking curves
were used to reveal the efficacy and safety of these therapies. RESULTS: In all,
23 randomized controlled trials with a total of 2720 patients were included in
our study. Cannabinoids and botulinum toxin had shown a significantly better
efficacy than placebo in the percentage of improved patients. Botulinum toxin
also showed such significant difference compared with tizanidine and baclofen. No
significant difference was found in spasticity scale. Cannabinoids, tizanidine
and diazepam had significantly more mild adverse effect reports than placebo.
Surface under the cumulative ranking curves suggested that cannabinoids,
botulinum toxin and transcutaneous electric nerve stimulation were preferable
therapies. CONCLUSIONS:
We recommended botulinum toxin as the optimal
intervention for multiple sclerosis-related spasticity. Cannabinoids and
transcutaneous electric nerve stimulation could also be considered as multiple
sclerosis-related spasticity treatments but their safety remained to be verified.

Langue : ANGLAIS