Efficacy and safety of tolperisone versus baclofen among Chinese patients with spasticity associated with spinal cord injury: a non-randomized retrospective study

Abstract

There are many medications available to treat spasticity, but the tolerability of medications is the main issue for choosing the best treatment. The objectives of this study were to compare the efficacy and adverse effects of tolperisone compared to baclofen among patients with spasticity associated with spinal cord injury. Patients received baclofen plus physical therapy (BAF+PT, n=135) or tolperisone plus physical therapy (TOL+PT, n=116), or physical therapy alone (PT, n=180). The modified Ashworth scale score, the modified Medical Research Council score, the Barthel Index score, and the Disability Assessment scale score were improved (P<0.05 for all) in all the patients at the end of 6 weeks compared to before interventions. After 6 weeks, the overall coefficient of efficacy of the intervention(s) in the BAF+PT, TOL+PT, and PT groups were 1.15, 0.45, and 0.05, respectively. The patients of the BAF+PT group reported asthenia, drowsiness, and sleepiness and those of the TOL+PT group reported dyspepsia and epigastric pain as adverse effects. When comparing drug interventions to physical therapy alone, both baclofen plus physical therapy and tolperisone plus physical therapy played a significant role in the improvement of daily activities of patients. Nonetheless, baclofen plus physical therapy was tentatively effective. Tolperisone plus physical therapy was slightly effective. In addition, baclofen caused adverse effects related to the sedative manifestation (Level of Evidence: III; Technical Efficacy Stage: 4).

Spinal Cord Injury Provoked Neuropathic Pain and Spasticity, and Their GABAergic Connection

“…However, its efficacy was less than baclofen combined with physical therapy (Table 4). 127 Voltage-gated L-type calcium channel inhibitor 1-(3-chlorophenethyl)-3-cyclopentylpyrimidine-2,4,6-(1H,3H,5H)-trione attenuated SCI-induced muscle spasms in mice by inhibiting Cav1.3 subunit specifically. This suggests Cav1.3 channel-mediated excitability inhibition could be a promising target for relieving SCI-spasticity in www.e-neurospine.org 661 the near future.…”

“…It inhibited spasticity with no adverse effects. However, its efficacy was less than baclofen combined with physical therapy ( Table 4 ) [ 127 ]. Voltage-gated L-type calcium channel inhibitor 1-(3-chlorophenethyl)-3-cyclopentylpyrimidine-2,4,6-(1H,3H,5H)-trione attenuated SCI-induced muscle spasms in mice by inhibiting Cav1.3 subunit specifically.…”

Intrathecal baclofen therapy and Covid-19 infection - report of three cases

“…They are usually treated with oral administration of baclofen (GABA-B agonist), tizanidine (alpha-2 adrenergic agonist) or tolperisone (sodium and calcium channel blocker at the level of brain stem) [2,3]. When oral therapy is insufficient or the patient does not tolerate the drug side effects, intrathecal therapy may be considered.…”

Screen-printed sensors for efficient potentiometric analysis of tolperisone hydrochloride in presence of its co-formulated drugs

“…Tolperisone (TOLP) which is chemically designated as 2-Methyl- 1-(4-methylphenyl)-3-piperidin-1-ylpropan-1-one hydrochloride (Fig. 1 ), belongs to the centrally acting muscle relaxant group and it is prescribed for symptomatic treatment of spasticity, muscle spasm, and osteoarthritis[ 1 ]. The reason behind using TOLP in the management of osteoarthritis is suggested to be due to the myokines (released with muscle contraction during function) interaction with structures such as synovial tissue, cartilage, and bone at a molecular level.…”