At least 1000 residents of Chennai suffer from stroke every month, and nearly 7.5 lakh people in the country suffer from stroke annually, according to Dr.M.R.Sivakumar, Head of Stroke & Vascular Neurology, Apollo Hospitals, Chennai.
Talking to Pharmabiz, he said one person die every 3.3 seconds in the country from stroke, and the disease has become the third largest killer disease in India, and more than 50 lakh people in the country were its victims. About 10% of the people suffering from stroke develop spasticity, a condition described by stiff or rigid muscles and immobility, and other post-stroke disabilities like hypoxia (brain damage) and Ischemic cerebral palsy.
Though doctors use many oral medicines to treat spasticity, Type A Botulinum Toxin injection has found to be more effective in treating the disease. Botox, the popular injection for spasticity, manufactured by the U.S. based pharmaceutical major Allergan, is also available in India. It has ability to block neuromuscular transmission through a three-step process, followed by the sprouting of new axon terminals, which results in the reestablishment of neuromuscular transmission, and thus the temporarily weakened spastic muscle is allowed to have more normal limb positioning and function. The drug has capability to allow improvement in mobility, positioning, sitting, toileting, hygiene and other activities of daily life when injected to people suffering from spasticity, said Dr.M.R.Sivakumar, also a consultant neurologist for the Cardiovascular and Vasculitis Research Foundation (VCF).
He said Botox has no side effects, unlike many of the oral medicines for spasticity, like developing drowsiness or fever. Once injected, the patient can lead a normal life for about six weeks to three months, and in some cases, even up to one year. However, the efficacy of the drug is also dependent on the ability of the doctor to decide and locate the correct muscle for injection. The drug has also found effective in treating spastic children, said Dr.Sivakumar.
However, the imported drug costs about Rs.18, 000 for 100 units, and in normal cases, it requires about 300 to 400 units at a time for administering the drug. The prohibitive cost of the drug is a major constraint for many poor patients in the country suffering from spasticity to go for this injection, said Dr.Sivakumar.