Neuro Muscular Junction Study (NMJ)

This study is currently recruiting participants. (see Contacts and Locations)
Verified July 2014 by Ipsen
Information provided by (Responsible Party):
Ipsen Identifier:
First received: September 6, 2012
Last updated: July 28, 2014
Last verified: July 2014

The aim of this study is to compare Dysport treatment results after current clinical practice injection technique and high-concentration dilution to the neuromuscular junction targeted injection technique and low-concentration dilution in the elbow joint assessed by Modified Ashworth Scale 4 weeks post treatment. The hypothesis is that one high volume injection centrally located in the area/band of the NMJ zones will be as effective as the technique used today in current medical practice.

Condition Intervention Phase
Arm Spasticity
Procedure: Current clinical practice technique and high-concentration dilution
Procedure: NMJ targeted technique and low-concentration dilution
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase III Prospective, Multi-center, Randomised, Evaluator-blinded Study to Compare Neuromuscular Junction (NMJ) Targeted Technique for Dysport® Injections in Upper Limb Spasticity Post Stroke or Traumatic Brain Injury to the Technique Used in Current Clinical Practice

Resource links provided by NLM:

Further study details as provided by Ipsen:

Primary Outcome Measures:
  • Modified Ashworth Scale (MAS) of elbow flexors [ Time Frame: 4 weeks ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Change from baseline for elbow flexors muscle tone as measured by the MAS [ Time Frame: Week 12 ] [ Designated as safety issue: No ]
  • Change from baseline for wrist flexors muscle tone as measured by the MAS [ Time Frame: Week 4 and 12 ] [ Designated as safety issue: No ]
  • Change from baseline of elbow flexors and wrist flexors combined as measured by the MAS [ Time Frame: Week 4 and 12 ] [ Designated as safety issue: No ]
  • Mean change from baseline of spasticity related pain measured by Visual Analogue Scale (VAS), assessed by the subject [ Time Frame: Week 4 and 12 ] [ Designated as safety issue: No ]
  • Injection pain measured by Visual Analogue Scale (VAS) [ Time Frame: Day 1 ] [ Designated as safety issue: No ]
  • Achievement of the primary goal measured by Goal Attainment Scale (GAS) [ Time Frame: Week 4 or 12 ] [ Designated as safety issue: No ]
  • Subject global evaluation of treatment effect [ Time Frame: Week 12 or 24 (at the latest) ] [ Designated as safety issue: No ]
    Categorised as follows: Much worse / Worse / Same / Better / Much better.

  • Investigator preference of injection technique [ Time Frame: Up to week 24 ] [ Designated as safety issue: No ]

Estimated Enrollment: 258
Study Start Date: September 2012
Estimated Study Completion Date: March 2015
Estimated Primary Completion Date: March 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Group 1
Current clinical practice technique and high-concentration dilution
Procedure: Current clinical practice technique and high-concentration dilution
The same number and sites of injections/deposits per muscle will be given as pre study. With a Dysport dilution of 300U/mL the volume to be injected will vary in the interval of 0.1 mL to 0.7 mL per muscle.
Experimental: Group 2
NMJ targeted technique and low-concentration dilution
Procedure: NMJ targeted technique and low-concentration dilution
A single injection per muscle will be given in the midline of the band of NMJ zones. With a Dysport dilution of 100U/mL the volume to be injected will vary in the interval of 0.4 mL to 2.0 mL per muscle.


Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Provision of written informed consent prior to any study related procedures
  • Subjects male or female, aged 18 or older
  • Upper limb spasticity post stroke or traumatic brain injury
  • Spasticity position pattern type 1, 3 or 4
  • Elbow flexor muscles spasticity MAS 2 to 3
  • At least 2 consecutive previous treatment cycles of BoNT-A for current diagnosis
  • The latest treatment cycle demonstrating good treatment efficacy where the Dysport dose administered was considered to be adequate according to Investigator judgement
  • Need of the same treatment modality as the previous treatment cycle,
  • Last BoNT-A treatment 12-24 weeks ago

Exclusion Criteria:

  • Poor response to BoNT-A treatment, according to Investigator
  • Need of Dysport doses >800U in the upper limb
  • Concomitant treatment with BoNT-A for other indications than spasticity
  • Any elbow flexor contracture prohibiting MAS evaluation and/or elbow flexion improvement of at least 1 step on the MAS
  • Cutaneous or joint inflammation in the affected upper limb
  • Is likely to start other spasticity treatment during the study
  • Is likely to start physiotherapy treatment during the study
  • Other ongoing neurological disorder (e.g., myasthenia gravis)
  • History of dysphagia or aspiration
  • Use of agents interfering with neuromuscular transmission (e.g., aminoglycosides)
  • Treated with an investigational medicinal product within 30 days before start of the study
  • Known sensitivity to BoNT-A or any components of Dysport,
  • Is at risk of pregnancy or is lactating. Females of childbearing potential must provide a negative pregnancy test (U-hCG) at visit 1 and must be using adequate contraception. Non childbearing potential is defined as post-menopause for at least one year, surgical sterilisation or hysterectomy at least three months before the start of the study,
  • Has a history of, or known current, problems with alcohol or drug abuse,
  • Has a mental condition rendering the subject unable to understand the nature, scope and possible consequences of the study, and/or evidence of an uncooperative attitude,
  • Has abnormal baseline findings, any other medical condition(s) or laboratory findings that, in the opinion of the investigator, might jeopardise the subject's safety or decrease the chance of obtaining satisfactory data needed to achieve the objective(s) of the study.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01682148

Contact: Ipsen Recruitment Enquiries

Aalborg Sygehus Nord Active, not recruiting
Aalborg, Denmark, 9000
Sydvestjysk Sygehus Withdrawn
Esbjerg, Denmark, 6700
Glostrup Hospital Recruiting
Glostrup, Denmark, 2600
Regionshospitalet Hammel Recruiting
Hammel, Denmark, 8450
Bispebjerg Hospital Recruiting
København NV, Denmark, 2400
Roskilde Hospital Recruiting
Roskilde, Denmark, 4000
Sygehus Sønderjylland Withdrawn
Sønderborg, Denmark, 6400
Vejle Hospital Recruiting
Vejle, Denmark, 7100
Regionshopsitalet Viborg Recruiting
Viborg, Denmark, 8800
Invalidiliitto Käpylä Rehab Center Withdrawn
Helsinki, Finland, 00251
North Karelia Central Hospital Recruiting
Joensuu, Finland, 80210
Central Hospital of Central Finland Recruiting
Jyväskylä, Finland, 40503
Invalidiliiton Lapin kontouskekus Withdrawn
Rovaniemi, Finland, 96400
Department of Neurology, Tampere University Hospital Withdrawn
Tampere, Finland, 33521
Haukeland University Hospital Recruiting
Bergen, Norway, 5021
Sykehuset Telemark HF Recruiting
Skien, Norway, , 3700
Mälarsjukhuset MSE Terminated
Eskilstuna, Sweden, 631-88
Sahlgrenska University Hospital Recruiting
Göteborg, Sweden
Hallands Sjukhus, Neurology Clinic Recruiting
Halmstad, Sweden, 30185
Sundsvall-Härnösand, Rehabilitation Medicine Recruiting
Härnösand, Sweden, 87182
Nyköpings Lasarett, Active, not recruiting
Nyköping, Sweden, 61185
Sophiahemmet, Neuroenheten Withdrawn
Stockholm, Sweden, 11486
Danderyds Hospital, Recruiting
Stockholm, Sweden, 18288
Neurology Clinic Stockholm Recruiting
Stockholm, Sweden, 114 33
Neurorehab Sävar Recruiting
Sävar, Sweden, 91831
Rehabilitation Center Gotland Recruiting
Visby, Sweden, 62184
Ystad Lasarett Recruiting
Ystad, Sweden, 27133
Universitetssjukhuset Örebro Withdrawn
Örebro, Sweden, 701 85
Örnsköldsviks Sjukhus, Neurology Clinic Recruiting
Örnsköldsvik, Sweden, 891 89
Östersunds Rehabilitation Center Recruiting
Östersund, Sweden, 83102
Sponsors and Collaborators
Study Director: Roger Belusa Ipsen
  More Information

No publications provided

Responsible Party: Ipsen Identifier: NCT01682148     History of Changes
Other Study ID Numbers: A-99-52120-162, 2011-005375-16
Study First Received: September 6, 2012
Last Updated: July 28, 2014
Health Authority: Sweden: Medical Products Agency
Denmark: Danish Medicines Agency
Finland: Finnish Medicines Agency
Norway: Norwegian Medicines Agency

Additional relevant MeSH terms:
Muscle Spasticity
Brain Injuries
Muscular Diseases
Musculoskeletal Diseases
Muscle Hypertonia
Neuromuscular Manifestations
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Brain Diseases
Central Nervous System Diseases
Craniocerebral Trauma
Trauma, Nervous System
Wounds and Injuries processed this record on September 14, 2014