Моделирование отдаленных результатов и риска смерти у пациентов с постинсультной спастичностью при проведении инъекций абоботулотоксина в структуре реабилитации

На сегодняшний день отсутствуют российские и международные исследования, оценивающие долгосрочную эффективность ботулинотерапии (инъекций абоботулотоксина – AбоБTA) на фоне проведения реабилитации у пациентов с постинсультной спастичностью с точки зрения их влияния на риск смерти от всех причин и развитие сердечно-сосудистых осложнений. В проведенном в Великобритании 10-летнем исследовании проанализировано влияние инъекций AбоБTA у пациентов со спастичностью после инсульта на отдаленные клинические (смертность от всех причин, развитие сердечно-сосудистых осложнений, продолжительность и качество жизни) и экономические (прямые медицинские расходы) результаты. Впервые была разработана модель для оценки клинической (продолжительность жизни с поправкой на ее качество) и экономической пользы проведения инъекций АбоБТА в структуре реабилитации по сравнению с реабилитацией без ботулинотерапии у пациентов с постинсультной спастичностью. Показано, что включение периодических инъекций АбоБТА в процесс реабилитации привело к снижению риска смерти от всех причин на 8,8%, увеличению продолжительности жизни на 13% (а с поправкой на ее качество – на 59% по сравнению с проведением реабилитации без ботулинотерапии) и показана эффективность с точки зрения затрат. Применение инъекций АбоБТА у пациентов со спастичностью после инсульта в структуре реабилитации экономически эффективно в долгосрочной перспективе и улучшает отдаленные результаты, включая выживаемость после инсульта.

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