Journal Club: Benefits of CITB therapy in CP persist into adulthood

In nonambulatory individuals with cerebral palsy (CP), the positive effects of continuous intrathecal baclofen (CITB) therapy last into adulthood. This was the main finding of a study in caretakers of 15 patients (7 female and 8 male) with a mean age of 31.8 years who had received CITB treatment. Most patients (12) were tetraplegic. To evaluate individual goals, ease of care, and pain, investigators used the Visual Analogue Scale (VAS) and, for physical and psychological well-being, the Child Health Questionnaire-Parent Form 50 (CHQ-PF 50). Investigators also assessed treatment-related hospitalization rates and the necessity for orthopedic surgery. This study was designed to ascertain whether the benefits of CITB therapy observed in an earlier study that was conducted during childhood persist into adulthood.

At 16 to 19 years after pump implantation, VAS scores had significantly improved for individual goals, ease of care, and pain. While CHQ-PF scores in the childhood study showed that mental health scores were significantly higher at 12-month follow-up compared with baseline, mental health status had returned to baseline. Change in health also did not differ significantly from baseline. As for treatment-related hospital admissions, the study showed about 1 such admission per about 3.6 years of CITB treatment. A full 80% of study participants indicated that they would opt for CITB treatment again and were positive about its effects.

THOUGHTS FROM DR FARBER

The long-term value of intrathecal pumps has not been clear-cut, but I have had several patients who appear to have benefited from them. It’s good to know the effects are likely to persist long after they age out of your practice.

Reference

Martens BHM, Iskander M, Soudant DL, et al. From childhood to adulthood: long-term assessment of continuous intrathecal baclofen therapy in non-ambulant spastic cerebral palsy. Eur J Paediatr Neurol. 2025;56:17-23. doi:10.1016/j.ejpn.2025.04.002