Authors' objectives: To assess the safety, effectiveness, cost-effectiveness, organizational issues related to the use of continuous ITB infusion for treatment of patients with severe spasticity or severe dystonia or having both conditions compared with conventional treatment.

Authors' recommendations: There was a good level of evidence on effectiveness (with There was substantial fair level of retrievable evidence to suggest that continuous ITB infusion was effective in reducing spasticity, reducing pain, improved function and quality of life in patients with severe spasticity who were unresponsive or cannot tolerate oral baclofen. Majority of the treatment goals were attained. Patients and caregivers were satisfied with the treatment. Although there was the risk of adverse events related to continuous ITB infusion, the treatment is considered relatively safe, minimally invasive and reversible. Continuous ITB infusion for treatment of patients with severe spasticity seemed to be cost-effective in some countries. There was limited fair level of retrievable evidence to suggest that continuous ITB infusion was also safe and effective in reducing dystonia, reducing spasticity, improved function and quality of life in patients with severe dystonia or having both spasticity and dystonia who were unresponsive or cannot tolerate oral baclofen. Complication rates were higher in children with dystonia compared with those having spasticity. There was no retrievable evidence on the cost-effectiveness of continuous ITB infusion for treatment of patients with severe dystonia or having both spasticity and dystonia. This treatment system requires long term monitoring by an experienced healthcare team. Besides proper training for the healthcare teams, patients and caregivers education has been critical in avoiding severe consequences of ITB withdrawal. Despite the large upfront cost for the procedure, the long-term effects can be potentially money saving.

Project Status: Completed

Year Published: 2014

URL for published report: http://www.moh.gov.my/index.php/pages/view/113

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Malaysia

Organisation Name: Malaysian Health Technology Assessment

Contact Address: Malaysian Health Technology Assessment Section, Ministry of Health Malaysia, Federal Government Administrative Centre, Level 4, Block E1, Parcel E, 62590 Putrajaya Malaysia Tel: +603 8883 1229

Contact Name: htamalaysia@moh.gov.my

Contact Email: htamalaysia@moh.gov.my

Copyright: Malaysian Health Technology Assessment (MaHTAS)