title: Systematic literature review of abobotulinumtoxinA in clinical trials for adult upper limb spasticity.
abstract: OBJECTIVE
  The aim of this study was to elucidate clinical trial efficacy, safety, and dosing practices of abobotulinumtoxinA (ABO) treatment in adult patients with upper limb spasticity (ULS).
  
  
  METHODS
  A systematic literature review was performed to identify randomized controlled trials and other comparative clinical studies of ABO in the treatment of adult ULS published in English between January 1991 and January 2013. Medical literature databases (PubMed, Cochrane Library, and EMBASE) were searched, and a total of 295 records were identified. Of these, 12 primary publications that evaluated ABO for the management of ULS were included in the final data report.
  
  
  RESULTS
  Total ABO doses ranged between 500 and 1500 U for ULS. Most of the studies in ULS showed statistically significant benefits (reduction in muscle tone based on Ashworth score) of ABO vs. placebo. Statistical significance was reached for most evaluations of spasticity using the Modified Ashworth Scale. Statistically significant effects on active movement and pain were demonstrated, albeit less consistently. ABO was generally well tolerated across the individual studies; most adverse events reported were considered unrelated to treatment. Adverse events considered associated with ABO treatment included fatigue, tiredness, arm pain, skin rashes, flu-like symptoms, worsening of spasm, and weakness.
  
  
  CONCLUSIONS
  On the basis of data extracted from 12 randomized clinical studies, a strong evidence base (9/12 studies) exists for the use of ABO to reduce ULS caused by stroke.
authors.affiliation: From the Department of Neurology, Loma Linda University School of Medicine, Loma Linda, California (KD, JJC); Loma Linda University, Schools of Pharmacy, Loma Linda, California (KD, JJC); and the Department of Physical Medicine and Rehabilitation, School of Medicine, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (HWW, MYL).
authors.forename: Khashayar
authors.initials: K
authors.lastname: Dashtipour
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Chen
authors.forename: Heather W
authors.initials: HW
authors.lastname: Walker
authors.forename: Michael Y
authors.initials: MY
authors.lastname: Lee
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004551:Elbow Joint / Q000503:physiopathology; D004599:Electric Stimulation Therapy; D005384:Finger Joint / Q000503:physiopathology; D006801:Humans; D009128:Muscle Spasticity / Q000188:drug therapy*; D016059:Range of Motion, Articular / Q000187:drug effects; D020521:Stroke / Q000188:drug therapy; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000503:physiopathology*; D014955:Wrist Joint / Q000503:physiopathology*
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A; C542869:abobotulinumtoxinA