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Intrathecal baclofen monotherapy and polyanalgesia were found reasonable for the management of chronic pain.
A recent systematic review findings showed that intrathecal baclofen (ITB) can be effective for improving chronic pain, function and quality of life in patients experiencing severe spasticity. The intrathecal drug delivery has been effective for treating various pain disorders. Among various pain-relieving agents, ITB has also been shown to relieve pain and spasms among patients with central neurological disorders but the analgesic activity is not clearly understood.
Owing to this, the present systematic review was conducted to characterize the efficacy of ITB in relieving pain, improving function and quality of life in patients with severe spasticity. The review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The primary endpoints included evaluation of analgesic efficacy and improvements in function. The secondary outcomes include assessment of the quality of life and adverse events.
A total of 393 studies was identified after the initial survey, among which only 20 studies (16 studies of ITB monotherapy + 4 studies of ITB polyanalgesia) met the inclusion criteria. The mean titrated doses of ITB varied from 140 to 627.9 μg daily. Among the 20 studies, a significant improvement in pain and spasticity & functional outcomes and quality of life was observed in 19 and 7 studies respectively.
These findings support the use of ITB for pain management and spasticity, but there is a need for well-designed studies to characterize ITB's analgesic efficacy among patients with severe spasticity.
Current Pain and Headache Reports
Intrathecal Baclofen Monotherapy and Polyanalgesia for Treating Chronic Pain in Patients with Severe Spasticity
Anuj Marathe et al.
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