Characteristics of Changes in Intrathecal Baclofen Dosage over Time due to Causative Disease

This study looks at how the dosage of intrathecal baclofen (ITB), a drug used to treat spasticity, changes over time in patients with different underlying conditions: hereditary spastic paraplegia (HSP), cerebral palsy (CP), and spinal cord injury (SCI). ITB therapy involves delivering baclofen directly into the cerebrospinal fluid to reduce muscle stiffness and spasms. The researchers followed patients for an average of 70 months, tracking changes in baclofen dosage and any adverse events. They found that the dosage adjustments varied depending on the specific condition causing the spasticity. Patients with HSP sometimes needed dosage reductions after several years, while those with CP often required gradual increases. Understanding these differences is important for doctors when managing long-term ITB treatment. The study highlights the need to consider the natural history of each disease to optimize baclofen dosage and minimize potential complications.

• 1
  In patients with hereditary spastic paraplegia (HSP), baclofen dosage was reduced after eight years following ITB introduction, and the treatment was terminated in one patient owing to disease progression.
• 2
  In patients with cerebral palsy (CP), the dosage increased gradually, and became constant in the 11th year. Severity and adverse event rates were higher in patients with cerebral palsy than in others.
• 3
  Patients with spinal cord injury (SCI) gradually increased their baclofen dosage throughout the entire observation period.