OnabotulinumtoxinA Improves Pain in Patients With Post-Stroke Spasticity: Findings From a Randomized, Double-Blind, Placebo-Controlled Trial Jörg Wissel,

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OnabotulinumtoxinA Improves Pain in Patients With Post-Stroke Spasticity: Findings From a Randomized, Double-Blind, Placebo-Controlled Trial Jörg Wissel, MD, Vaidyanathan Ganapathy, PhD, MPharm, Anthony B. Ward, MD, FRCP, Jörgen Borg, MD, PhD, Per Ertzgaard, MD, Christoph Herrmann, MD, Anders Haggstrom, MD, Mohamed Sakel, MD, Julia Ma, PhD, Rozalina Dimitrova, MD, MPH, Antony Fulford- Smith, MB, BS, MRCGP, Patrick Gillard, PharmD, MS Journal of Pain and Symptom Management Volume 52, Issue 1, Pages 17-26 (July 2016) DOI: 10.1016/j.jpainsymman.2016.01.007 Copyright © 2016 The Authors Terms and Conditions

Fig. 1 Mean changea from baseline in PNRS score during the double-blind and open-label treatment phases. Error bars represent 95% CIs. aLeast squares means (adjusted for covariate) on change from baseline pain scores. bP < 0.05 versus placebo. OnabotA = onabotulinumtoxinA; PNRS = Pain Numeric Rating Scale. Journal of Pain and Symptom Management 2016 52, 17-26DOI: (10.1016/j.jpainsymman.2016.01.007) Copyright © 2016 The Authors Terms and Conditions

Fig. 2 Proportions of patients who achieved ≥30% and ≥50% reductions in pain score from baseline at Week 12, Week 24/10 weeks after second injection, and at Week 52 in the subgroup of patients with baseline pain scores ≥4 (“pain subgroup”). aP < 0.05 versus placebo. OnabotA = onabotulinumtoxinA. Journal of Pain and Symptom Management 2016 52, 17-26DOI: (10.1016/j.jpainsymman.2016.01.007) Copyright © 2016 The Authors Terms and Conditions

Fig. 3 Proportions of patients with ≥1- and ≥2-point reductions in pain interference with work from baseline. Pain interference with work was measured using the SF-12 Item #5. Patients with a pain interference score of 3–5 (moderate to severe) at baseline were evaluated. aP < 0.05 versus placebo. OnabotA = onabotulinumtoxinA; SF-12 = Short Form-12. Journal of Pain and Symptom Management 2016 52, 17-26DOI: (10.1016/j.jpainsymman.2016.01.007) Copyright © 2016 The Authors Terms and Conditions

Fig. 4 Exploratory analyses. Correlation between change in pain and change in REPAS-26 total score at Week 12 in patients with moderate-to-severe spasticity at baseline and at Week 52 among patients with moderate-to-severe spasticity that received placebo + SC during the double-blind portion of the study, followed by onabotulinumtoxinA + SC during the open-label phase. REPAS = REsistance to PAssive movement Scale; SC = standard care. Journal of Pain and Symptom Management 2016 52, 17-26DOI: (10.1016/j.jpainsymman.2016.01.007) Copyright © 2016 The Authors Terms and Conditions