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Neck Pain and Cervical Dystonia: Treatment Outcomes from CD PROBE (Cervical Dystonia Patient Registry for Observation of OnabotulinumtoxinA Efficacy)
Author(s) -
Charles P. David,
Manack Adams Aubrey,
Davis Thomas,
Bradley Kathryn,
Schwartz Marc,
Brin Mitchell F.,
Patel Atul T.
Publication year - 2016
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12408
Subject(s) - cervical dystonia , medicine , neck pain , spasmodic torticollis , botulinum toxin , physical therapy , rating scale , population , brief pain inventory , clinical trial , visual analogue scale , dystonia , torticollis , anesthesia , chronic pain , surgery , psychology , developmental psychology , alternative medicine , environmental health , pathology , psychiatry
Background Pain is a prevailing feature of cervical dystonia ( CD ), the most common form of focal dystonia. This analysis examined pain relief after onabotulinumtoxinA treatment in CD subjects with moderate/severe pain from the Cervical Dystonia Patient Registry for Observation of OnabotulinumtoxinA Efficacy ( CD PROBE ). Methods CD PROBE was a prospective, multicenter, observational registry of CD subjects who were naïve to botulinum toxin (Bo NT ), new to physician, or had not received Bo NT within ≥ 16 weeks if in a clinical trial. Subjects were eligible for 3 treatments, with variable session intervals. Descriptive and inferential statistics were utilized to evaluate the change in pain scores in the population with moderate/severe neck pain at baseline (Pain Numeric Rating Scale [ PNRS ] score 4 to 10). Results Of 1046 enrolled, 733 (70.7%) had moderate/severe neck pain at baseline. Postinjection pain questionnaire responses 4 to 6 weeks after each of the 3 treatments revealed that a majority of subjects (67.1%, 72.4%, and 76.4%) reported pain relief; mean time to pain relief was 7.1, 7.4, and 7.6 days. All pain scales showed significant improvements from baseline to final visit (all P < 0.0001): PNRS , mean 6.6 to 3.8; CD Impact Profile‐58 Pain and Discomfort subscale, mean 78.7 to 56.5; and Toronto Western Spasmodic Torticollis Rating Scale Pain subscale, mean 12.6 to 8.5. Multivariable regression models showed that initial pain score significantly contributed to the final pain score for all scales. Conclusion Results from this real‐world clinical registry indicate that a majority of CD subjects with moderate/severe neck pain experience significant relief following onabotulinumtoxinA treatment.