Advantages of ITB Therapy

Jason F., living with spinal cord injury. Receiving ITB Therapy since 1991.

In addition to statistically significant reductions in severe spasticity,^1-4 studies have shown that ITB Therapy offers the potential for reduced central nervous system side effects that are associated with oral medications,⁵ improvements in independence and caregiving,^6-12 as well as high patient and caregiver satisfaction.^9,13,14

Additionally, studies show reduction in spasticity-related pain,^7,15,16 and improvement in function and physical activity.^7,10,15,17

Reduced side effects

Because ITB Therapy delivers baclofen directly to the spinal cord, it relieves spasticity with smaller amounts of medication than when taken orally. This helps minimize systemic side effects.

Introducing Lioresal® Intrathecal directly into the intrathecal space permits effective CSF concentrations to be achieved with resultant plasma concentrations 100 times less than those occurring with oral administration.¹⁹

Improvements in independence and caregiving

In at least seven studies the therapy has helped people become more independent, allowing them to perform activities of daily living including feeding or dressing themselves, sitting more comfortably, or transferring more easily.^6-12

Physician, patient, and caregiver satisfaction

Physician satisfaction
In a clinical study, 87% of physicians rated their overall satisfaction with ITB Therapy for each patient as “good” or “very good.”¹⁵

Patient satisfaction
In a clinical study, the authors concluded that “ITB Therapy demonstrated the highest satisfaction rating compared to all oral treatments: the mean rating score of 4.47 on a scale of 5 indicates substantially more gratification among patients than the next most satisfactory...(which had) a mean score of 3.89.”¹⁴

In another study, 82% of patients and caregivers indicated they would repeat their decision to implant the pump. In addition, 85% reported their goals were fully or partially met.⁷

Caregiver satisfaction
A high rate of caregiver satisfaction with ITB Therapy has also been reported in the following studies.

• More than 81% of 80 care providers “strongly agreed” that they would repeat the decision to undergo the pump procedure⁹
• More than 88% (15 of 17) would recommend the therapy to others¹³

1. Gilmartin R, Bruce D, Storrs BB, et al. Intrathecal baclofen for management of spastic cerebral palsy: multicenter trial. J Child Neurol. 2000;15(2):71-77.
2. Ivanhoe CB, Francisco GE, McGuire JR, Subramanian T, Grissom SP. Intrathecal baclofen management of poststroke spastic hypertonia: implications for function and quality of life. Arch Phys Med Rehabil. 2006;87(11):1509-1515
3. Meythaler JM, Guin-Renfroe S, Law C, Grabb P, Hadley MN. Continuously infused intrathecal baclofen over 12 months for spastic hypertonia in adolescents and adults with cerebral palsy. Arch Phys Med Rehabil. 2001;82(2):155-161.
4. Penn RD. Intrathecal baclofen for spasticity of spinal origin: seven years experience. J Neurosurg. 1992;77(2):236-240.
5. Loubser PG, Narayan RK, Sandin KJ, Donovan WH, Russell KD. Continuous infusion of intrathecal baclofen: long-term effects on spasticity in spinal cord injury. Paraplegia. 1991:29(1):48-64.
6. Nance P, Schryvers O, Schmidt B, Dubo H, Loveridge B, Fewer D. Intrathecal baclofen therapy for adults with spinal spasticity: therapeutic efficacy and effect on hospital admissions. Can J Neurol Sci. 1995 Feb; 22(1):22-29
7. Krach LE, Nettleton A, Klempka B. Satisfaction of individuals treated long-term with continuous infusion of intrathecal baclofen by implanted programmable pump. Pediatr Rehabil. 2006; 9(3): 210-218.
8. Krach LE, Kriel RL, Gilmartin RC, et al. GMFM 1 year after continuous intrathecal baclofen infusion. Ped Rehabil. 2005;8(3):207-213.
9. Gooch JL, Oberg WA, Grams B, Ward LA, Walker ML. Care provider assessment of intrathecal baclofen in children. Dev Med Child Neurol. 2004;46(8):548-552.
10. Parke B, Penn RD, Savoy SM, Corcos D. Functional outcome following delivery of intrathecal baclofen. Arch Phys Med Rehabil. 1989;70(1):30-32.
11. Stempien L, Tsai T. Intrathecal baclofen pump use for spasticity: a clinical survey. Am J Phys Med Rehabil. 2000;79(6):536-541.
12. Azouvi P, Mane M, Theibaut JB, Denys P, Remy-Neris O, Bussel B. Intrathecal improvement and long-term follow up. Arch Phys Med Rehabil. 1996;77(1):35-39.
13. Campbell WM, Ferrel A, McLaughlin JF, et al. Long-term safety and efficacy of continuous intrathecal baclofen. Dev Med Child Neurol 2002;44(10):660-665.
14. Rizzo MA, Hadjimichael OC, Preiningerova J, Vollmer TL. Prevalence and treatment of spasticity reported by multiple sclerosis patients. Mult Scler. 2004;10(5):589-595.
15. Guillaume D, Van Havenbergh A, Vloeberghs M, Vidal J, Roeste G. A clinical study of intrathecal baclofen using a programmable pump for intractable spasticity. Arch Phys Med Rehabil. 2005;86(11):2165-2171.
16. Middel B, Kuipers-Upmeijer H, Bouma J, et al. Effect of intrathecal baclofen delivered by an implanted programmable pump on health related quality of life in patients with severe spasticity. J Neurol Neurosurg Psychiatry. 1997;63(2):204-209.
17. Dario A, Scamoni C, Bono G, Ghezzi A, Zaffaroni M. Functional improvement in patients with severe spinal spasticity treated with chronic intrathecal baclofen infusion. Funct Neurol. 2001;16(4):311-315.
18. Koman LA, Paterson Smith B, eds. Management of Spasticity in Cerebral Palsy: The Role of Intrathecal Baclofen. Towson, MD: Data Trace Publishing Company; 2005.
19. Lioresal® Intrathecal (baclofen injection) Drug Package Insert.

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