Treatment with Botulinum toxin A in a total population of children with cerebral palsy - A retrospective cohort registry study

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@article{143f7a372d86450a973a3639b10aab17,
title = "Treatment with Botulinum toxin A in a total population of children with cerebral palsy - A retrospective cohort registry study",
abstract = "Background: Botulinum toxin A (BTX-A) has been used to reduce spasticity in children with cerebral palsy (CP) for decades. The purpose of this study was to analyze to what extent BTX-A treatment was used to treat spasticity in a total population of children with CP. We investigated 1) the use of BTX-A in relation to age, sex, and Gross Motor Function Classification System (GMFCS) level, 2) the most common muscle groups treated with BTX-A in relation to the same variables, and 3) changes in the proportions of children treated with BTX-A between two time points (2010 and 2015). Methods: The study was based on data from CPUP, a combined Swedish follow-up program and national healthcare registry, comprising >95{\%} of all children with CP in Sweden. The participants (N = 3028) were born in 2000 or later. Potential BTX-A treatment and treated muscle groups were included from all CPUP assessments recorded in the registry in 2014-2015. In Aim 3, BTX-A administration in 3-5 year-olds at two time points was assessed. Crosstabs and 95{\%} confidence intervals (CIs) for binominal proportions were calculated and logistic regression was used to regress age, sex, and GMFCS level on BTX-A treatment. Muscle groups treated with BTX-A were assessed using crosstabs and 95{\%} CIs. Proportional change in BTX-A treatment over a 5-year period was analyzed using chi-square. Results: We included 3028 children (57{\%} boys; median age 7 years) of whom 26{\%} received BTX-A. Significantly more boys (28{\%}) than girls (23{\%}) received BTX-A (OR = 1.25, [95{\%} CI 1.05-1.48]). Significant differences were found for age and GMFCS levels; 4-6 year-olds and those at GMFCS III-IV were more likely to receive BTX-A. BTX-A treatment in the gastrocnemius muscle was most common in the 4-6 year-olds and at GMFCS I-III, whereas treatment of the hamstring and adductor muscles was more common in older children and at GMFCS IV-V. No significant change in the proportion of BTX-A administered in 2010 and 2015 was demonstrated. Conclusions: BTX-A treatment differed based on age, sex, and GMFCS level. Proportion of BTX-A treatment in Sweden has remained stable during the past five years.",
keywords = "Age, Botulinum toxin a, Cerebral palsy, CPUP, GMFCS level, Registry, Sex, Spasticity",
author = "Maria Franz{\'e}n and Gunnar H{\"a}gglund and Ann Alriksson-Schmidt",
year = "2017",
month = "12",
day = "11",
doi = "10.1186/s12891-017-1880-y",
language = "English",
volume = "18",
journal = "BMC Musculoskeletal Disorders",
issn = "1471-2474",
publisher = "BioMed Central",
number = "1",

}