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Study Of GSK1358820 In Patients With Post-Stroke Upper Limb Spasticity

A Multicenter Study to Evaluate the Efficacy and Safety in Patients With Post-Stroke Upper Limb Spasticity Receiving a Double-Blind, Placebo-Controlled GSK1358820 Treatment Followed by an Open-Label GSK1358820 Treatment

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT00460564
Enrollment
109
Registered
2007-04-16
Start date
2007-05-31
Completion date
2008-12-31
Last updated
2017-05-30

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Post-Stroke Spasticity, Cerebrovascular Accident

Keywords

Spasticity, Post-Stroke, botulinum toxin type A, Upper Limb

Brief summary

This is a study to confirm the superior efficacy of a single treatment of GSK1358820 over placebo in patients with post-stroke upper limb spasticity of both the wrist and finger flexors using the Modified Ashworth Scale (MAS) wrist score.

Detailed description

This is a study to confirm the superior efficacy of a single treatment of GSK1358820 over placebo in patients with post-stroke upper limb spasticity of both the wrist and finger flexors using the Modified Ashworth Scale (MAS) wrist score.

Interventions

DRUGPlacebo

Placebo

botulinum toxin type A

Sponsors

GlaxoSmithKline
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No

Inclusion criteria

Subjects eligible for enrollment in the study must meet all of the following criteria: * Patients with upper limb spasticity who are at least 6 months post stroke and present with spasticity of both the wrist and fingers at the start of double-blind phase (Visit 2). * Wrist flexor muscle tone of ≥3 and finger flexor muscle tone of ≥2 on the MAS, and at least one functional disability item (i.e., hygiene, pain, dressing or limb posture) with a rating of ≥2 on the Disabilty Assessment Scale (DAS) at the start of double-blind phase (Visit 2). * Male or female between 20 and 80 years of age at the time of informed consent. For males, only those who can practice contraception during the study period are eligible. * ≥40kg in weight at the start of double-blind phase (Visit 2). * Inpatient or outpatient; however, the hospitalization status must remain unchanged during the double-blind phase. * Written informed consent from the subject him/herself. If the subject's signature is not legible, the attendance of a witness is required.

Exclusion criteria

* A subject will not be eligible for inclusion in this study if any of the following criteria apply: * Bilateral hemiplegia or quadriplegia. * Presence of fixed contractures of the wrist and/or fingers (absence of range of motion). * Profound atrophy of the muscles to be injected. * Previous surgical intervention, phenol block, ethanol block, or muscle afferent block (MAB) for wrist and/or finger spasticity. * Casting of the study upper limb within 3 months prior to the start of double-blind phase (Visit 2). * Current treatment with intrathecal baclofen. * Use of peripheral muscle relaxants (dantrolene sodium, suxamethonium chloride, pancuronium bromide, vecuronium bromide, rocuronium bromide). * Concurrent use of antibiotics that interfere with neuromuscular transmission, such as aminoglycoside antibiotics (e.g., streptomycin sulfate, kanamycin sulfate, gentamicin sulfate, neomycin sulphate, spectinomycin hydrochloride), polypeptide antibiotics (e.g., polymixin B sulfate), lincomycin antibiotics (e.g., lincomycin hydrochloride, clindamycin), and enviomycin sulfate. * Previous botulinum toxin therapy. * Diagnosis of systemic neuromuscular disorders (e.g., myasthenia gravis, Lambert-Eaton syndrome, amyotrophic lateral sclerosis). * Females who are pregnant, nursing, may be pregnant, or planning a pregnancy during the study period. * Known allergy or hypersensitivity to any ingredient of study medication (e.g., human serum albumin). * Presence of psychiatric disorder or impairment of intellectual function that may interfere with the subject's ability to give informed consent or the conduct of the study. * Bedridden patients. * Presence of clinically unstable severe cardiovascular disease. * Presence of clinically significant severe renal, hepatic or respiratory disease. * Infection or dermatological condition at the proposed injection sites. * Previous or planned participation in another clinical study (including the lower limb spasticity study of GSK1358820) within 6 months prior to the start of double-blind phase (Visit 2). * Others whom the investigator or sub investigator considers not eligible for the study. * Clinically significant severe reduction of muscle strength. * Angle closure glaucoma or its preposition (narrow angle).

Design outcomes

Primary

MeasureTime frameDescription
Area Under the Curve (AUC) for the Change From Baseline in Modified Ashworth Scale (MAS) Wrist Score to the End of the DB Phase (Week 12) in the High-dose GroupsBaseline, Week 12Change from baseline in MAS wrist score using a 6-point scale (0, 1, 1+ \[regarded as 1.5\], 2, 3, and 4; 0=no increase in muscle tone; 4=affected part\[s\] rigid in flexion/extension) to each time point in the DB phase was calculated. In the graph plotting time points on the horizontal axis and changes from baseline on the vertical axis, the area surrounded by the MAS wrist score change curve and the horizontal axis was calculated and used as a summary index (AUC) for assessment of the MAS wrist score. Negative changes from baseline indicate improvement, and the AUC has a negative sign.

Secondary

MeasureTime frameDescription
Mean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12The investigator assessed MAS wrist score using a 6-point scale (0, 1, 1+, 2, 3, and 4; 0=No increase in muscle tone to 4=Affected part\[s\] rigid in flexion or extension) at each time point in the double-blind phase. The +1 (slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder \[less than half\] of ROM \[range of motion\]) of MAS score is regarded as score 1.5.
Mean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12The investigator assessed MAS finger score using a 6-point scale (0, 1, 1+, 2, 3, and 4; 0=No increase in muscle tone to 4=Affected part\[s\] rigid in flexion or extension) at each time point in the double-blind phase. The +1 (slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder \[less than half\] of ROM \[range of motion\]) of MAS score is regarded as score 1.5.
Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12DAS scores of Hygiene, Pain, Dressing, and Limb posture were assessed using a 4-point scale (0=No functional disability to 3=Severe disability). Prior to the first injection, the investigator, in consultation with the participant, selected one functional disability item and assessed it as a principal measure at each time point in the double-blind phase.
Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12DAS score of Hygiene was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point in double-blind phase.
Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12DAS score of pain was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point in the double-blind phase.
Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12DAS score of Dressing was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point in the double-blind phase.
Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12DAS score of Limb Posture was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point in the double-blind phase.
Mean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point in the double-blind phase.
Mean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point in the double-blind phase.
Mean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseBaseline; Weeks 1, 4, 6, 8, and 12The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point in the double-blind phase.
Area Under the Curve (AUC) for the Change From Baseline in Modified Ashworth Scale (MAS) Wrist Score to the End of the DB Phase (Week 12) in the Low-dose GroupsBaseline, Week 12Change from baseline in MAS wrist score using a 6-point scale (0, 1, 1+ \[regarded as 1.5\], 2, 3, and 4; 0=no increase in muscle tone; 4=affected part\[s\] rigid in flexion/extension) to each time point in the DB phase was calculated. In the graph plotting time points on the horizontal axis (HA) and changes from baseline on the vertical axis, the area surrounded by the MAS wrist score change curve and the HA was calculated and used as a summary index (AUC) for assessment of the MAS wrist score. Negative changes from baseline indicate improvement, and the area under the AUC has a negative sign.
Mean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The investigator assessed the MAS finger score using a 6-point scale (0, 1, 1+, 2, 3, and 4; 0=No increase in muscle tone to 4=Affected part\[s\] rigid in flexion or extension) at each time point from baseline (at the start of the double-blind phase) to week 48. The +1 (slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder \[less than half\] of ROM \[range of motion\]) of MAS score is regarded as score 1.5.
Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)DAS scores of Hygiene, Pain, Dressing, and Limb posture were assessed using a 4-point scale (0=No functional disability to 3=Severe disability). Prior to the first injection, the investigator, in consultation with the participant, selected one functional disability item and assessed it as a principal measure at each time point from baseline (at the start of the double-blind phase) to Week 48.
Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The DAS score of Hygiene was assessed using a 4-point scale (0=No functional disability; 3=Severe disability) at each time point from baseline (at the start of the double-blind phase) to Week 48. BTX was injected in participants up to 3 times from Week 12 to Week 36 when participants met re-injection criteria. Measurements were taken at each point until Week 48 and summarized by the number of weeks after the re-injection in individuals (4, 8, and 12 weeks after each injection) in open-label phase; thus, measurements could have been taken up to Week 48 (12 weeks after the Week 36 injection).
Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The DAS score of Pain was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point from baseline (at the start of the double-blind phase) to Week 48. BTX was injected in participants up to 3 times from Week 12 to Week 36 when participants met re-injection criteria. Measurements were taken at each point until Week 48 and summarized by the number of weeks after the re-injection in individuals (4, 8, and 12 weeks after each injection) in open-label phase; thus, measurements could have been taken up to Week 48 (12 weeks after the Week 36 injection).
Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The DAS score of Dressing was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point from baseline (at the start of the double-blind phase) to Week 48. BTX was injected in participants up to 3 times from Week 12 to Week 36 when participants met re-injection criteria. Measurements were taken at each point until Week 48 and summarized by the number of weeks after the re-injection in individuals (4, 8, and 12 weeks after each injection) in open-label phase; thus, measurements could have been taken up to Week 48 (12 weeks after the Week 36 injection).
Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The DAS score of Limb Posture was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point from baseline (at the start of the double-blind phase) to Week 48. BTX was injected in participants up to 3 times from Weeks 12 to 36 when participants met re-injection criteria. Measurements were taken at each point until Week 48 and summarized by the number of weeks after the re-injection in individuals (4, 8, and 12 weeks after each injection) in open-label phase; thus, measurements could have been taken up to Week 48 (12 weeks after the Week 36 injection).
Mean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point from baseline (at the start of the double-blind phase) to Week 48.
Mean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point from baseline (at the start of the double-blind phase) to Week 48.
Mean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point from baseline (at the start of the double-blind phase) to Week 48.
Mean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseBaseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)The investigator assessed the MAS wrist score using a 6-point scale (0, 1, 1+, 2, 3, and 4; 0=no increase in muscle tone to 4=affected part\[s\] rigid in flexion or extension) at each time point from baseline (at the start of the double-blind phase) to week 48. The +1 (slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (\[less than half\] of ROM \[range of motion\]) of MAS score is regarded as score 1.5.

Countries

Japan

Participant flow

Participants by arm

ArmCount
High-Dose BTX
BTX (GSK1358820) 200U (4 mL) was injected into the wrist and finger muscles, and 40U (0.8 mL) into the thumb muscles if thumb spasticity was present in the 12-week double-blind phase (DB) (once at Week 0)
51
High-Dose Placebo
Placebo 4 mL was injected into the wrist and finger muscles, and 0.8 mL into the thumb muscles if thumb spasticity was present in the 12-week double-blind phase (DB) (once at Week 0)
26
Low-Dose BTX
BTX (GSK1358820) 120U (2.4 mL) was injected into the wrist and finger muscles, and 30U (0.6 mL) into the thumb muscles if thumb spasticity was present in double-blind phase in the 12-week (DB) (once at Week 0)
21
Low-Dose Placebo
Placebo 2.4 mL was injected into the wrist and finger muscles, and 0.6 mL into the thumb muscles if thumb spasticity was present in the 12-week double-blind phase (DB) (once at Week 0)
11
Total109

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005FG006FG007
Double-Blind Phase (12 Weeks)Adverse Event31000000
Double-Blind Phase (12 Weeks)Withdrawal by Subject10000000
Open-Label Phase (36 Weeks)Adverse Event00003520
Open-Label Phase (36 Weeks)Concentrate on Treatment of Diabetes00001000
Open-Label Phase (36 Weeks)Withdrawal by Subject00005100

Baseline characteristics

CharacteristicHigh-Dose BTXHigh-Dose PlaceboLow-Dose BTXLow-Dose PlaceboTotal
Age, Continuous63.5 years
STANDARD_DEVIATION 9.32
63.6 years
STANDARD_DEVIATION 11.03
62.7 years
STANDARD_DEVIATION 9.74
62.3 years
STANDARD_DEVIATION 9.61
63.2 years
STANDARD_DEVIATION 9.73
Race/Ethnicity, Customized
Asian-Japanese
51 participants26 participants21 participants11 participants109 participants
Sex: Female, Male
Female
15 Participants12 Participants2 Participants6 Participants35 Participants
Sex: Female, Male
Male
36 Participants14 Participants19 Participants5 Participants74 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
EG007
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —— / —— / —— / —
other
Total, other adverse events
17 / 5112 / 268 / 216 / 1121 / 4312 / 2314 / 2011 / 11
serious
Total, serious adverse events
6 / 513 / 261 / 210 / 114 / 433 / 234 / 200 / 11

Outcome results

Primary

Area Under the Curve (AUC) for the Change From Baseline in Modified Ashworth Scale (MAS) Wrist Score to the End of the DB Phase (Week 12) in the High-dose Groups

Change from baseline in MAS wrist score using a 6-point scale (0, 1, 1+ \[regarded as 1.5\], 2, 3, and 4; 0=no increase in muscle tone; 4=affected part\[s\] rigid in flexion/extension) to each time point in the DB phase was calculated. In the graph plotting time points on the horizontal axis and changes from baseline on the vertical axis, the area surrounded by the MAS wrist score change curve and the horizontal axis was calculated and used as a summary index (AUC) for assessment of the MAS wrist score. Negative changes from baseline indicate improvement, and the AUC has a negative sign.

Time frame: Baseline, Week 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureValue (MEAN)Dispersion
High-Dose BTXArea Under the Curve (AUC) for the Change From Baseline in Modified Ashworth Scale (MAS) Wrist Score to the End of the DB Phase (Week 12) in the High-dose Groups-10.397 Score*weekStandard Deviation 8.9313
High-Dose PlaceboArea Under the Curve (AUC) for the Change From Baseline in Modified Ashworth Scale (MAS) Wrist Score to the End of the DB Phase (Week 12) in the High-dose Groups-3.567 Score*weekStandard Deviation 4.7189
p-value: <0.00195% CI: [-10.567, -3.093]t-test, 2 sided
Secondary

Area Under the Curve (AUC) for the Change From Baseline in Modified Ashworth Scale (MAS) Wrist Score to the End of the DB Phase (Week 12) in the Low-dose Groups

Change from baseline in MAS wrist score using a 6-point scale (0, 1, 1+ \[regarded as 1.5\], 2, 3, and 4; 0=no increase in muscle tone; 4=affected part\[s\] rigid in flexion/extension) to each time point in the DB phase was calculated. In the graph plotting time points on the horizontal axis (HA) and changes from baseline on the vertical axis, the area surrounded by the MAS wrist score change curve and the HA was calculated and used as a summary index (AUC) for assessment of the MAS wrist score. Negative changes from baseline indicate improvement, and the area under the AUC has a negative sign.

Time frame: Baseline, Week 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureValue (MEAN)Dispersion
High-Dose BTXArea Under the Curve (AUC) for the Change From Baseline in Modified Ashworth Scale (MAS) Wrist Score to the End of the DB Phase (Week 12) in the Low-dose Groups-10.036 Score*weekStandard Deviation 7.7743
High-Dose PlaceboArea Under the Curve (AUC) for the Change From Baseline in Modified Ashworth Scale (MAS) Wrist Score to the End of the DB Phase (Week 12) in the Low-dose Groups-6.227 Score*weekStandard Deviation 8.6584
Secondary

Mean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point from baseline (at the start of the double-blind phase) to Week 48.

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL1.90 Points on a scaleStandard Deviation 1.513
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL1.36 Points on a scaleStandard Deviation 1.194
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL1.20 Points on a scaleStandard Deviation 1.508
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL1.74 Points on a scaleStandard Deviation 1.067
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL1.29 Points on a scaleStandard Deviation 1.33
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL1.47 Points on a scaleStandard Deviation 1.47
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL1.30 Points on a scaleStandard Deviation 1.261
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL1.56 Points on a scaleStandard Deviation 1.26
High-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL1.37 Points on a scaleStandard Deviation 1.196
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL2.06 Points on a scaleStandard Deviation 1.924
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL1.45 Points on a scaleStandard Deviation 1.036
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL1.71 Points on a scaleStandard Deviation 1.49
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL1.70 Points on a scaleStandard Deviation 1.222
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL1.78 Points on a scaleStandard Deviation 1.204
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL1.43 Points on a scaleStandard Deviation 1.207
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL1.00 Points on a scaleStandard Deviation 1.414
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL1.91 Points on a scaleStandard Deviation 1.973
High-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL2.28 Points on a scaleStandard Deviation 1.965
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL1.25 Points on a scaleStandard Deviation 1
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL0.95 Points on a scaleStandard Deviation 1.224
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL0.94 Points on a scaleStandard Deviation 1.731
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL1.33 Points on a scaleStandard Deviation 1.68
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL1.69 Points on a scaleStandard Deviation 1.778
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL1.00 Points on a scaleStandard Deviation 1.211
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL1.00 Points on a scaleStandard Deviation 2.062
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL1.89 Points on a scaleStandard Deviation 1.453
Low-Dose BTXMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL1.78 Points on a scaleStandard Deviation 1.563
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL2.43 Points on a scaleStandard Deviation 1.134
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL2.00 Points on a scaleStandard Deviation 1.512
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL0.82 Points on a scaleStandard Deviation 1.662
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL2.29 Points on a scaleStandard Deviation 1.704
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL2.43 Points on a scaleStandard Deviation 1.512
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL0.73 Points on a scaleStandard Deviation 0.786
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL1.88 Points on a scaleStandard Deviation 2.167
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL1.75 Points on a scaleStandard Deviation 1.282
Low-Dose PlaceboMean Change From Baseline (at the Start of the DB Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL1.91 Points on a scaleStandard Deviation 2.343
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point from baseline (at the start of the double-blind phase) to Week 48.

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL1.61 Points on a scaleStandard Deviation 2.03
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL1.91 Points on a scaleStandard Deviation 2.094
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL1.71 Points on a scaleStandard Deviation 1.979
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL2.29 Points on a scaleStandard Deviation 2.163
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL2.86 Points on a scaleStandard Deviation 1.682
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL2.20 Points on a scaleStandard Deviation 1.735
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL2.55 Points on a scaleStandard Deviation 1.791
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL1.93 Points on a scaleStandard Deviation 2.005
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL2.00 Points on a scaleStandard Deviation 2
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL1.71 Points on a scaleStandard Deviation 1.347
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL2.55 Points on a scaleStandard Deviation 1.214
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL1.83 Points on a scaleStandard Deviation 1.403
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL1.83 Points on a scaleStandard Deviation 1.466
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL2.78 Points on a scaleStandard Deviation 1.957
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL2.67 Points on a scaleStandard Deviation 1.782
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL2.29 Points on a scaleStandard Deviation 1.724
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL2.82 Points on a scaleStandard Deviation 1.888
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL2.00 Points on a scaleStandard Deviation 1.612
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL1.11 Points on a scaleStandard Deviation 1.641
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL1.13 Points on a scaleStandard Deviation 1.586
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL1.11 Points on a scaleStandard Deviation 1.054
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL1.00 Points on a scaleStandard Deviation 1
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL0.56 Points on a scaleStandard Deviation 1.825
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL0.78 Points on a scaleStandard Deviation 1.957
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL1.21 Points on a scaleStandard Deviation 1.548
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL1.13 Points on a scaleStandard Deviation 1.708
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL1.00 Points on a scaleStandard Deviation 1
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL2.38 Points on a scaleStandard Deviation 2.134
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL2.25 Points on a scaleStandard Deviation 2.121
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL2.71 Points on a scaleStandard Deviation 2.289
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL1.88 Points on a scaleStandard Deviation 2.167
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL2.86 Points on a scaleStandard Deviation 2.41
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL1.36 Points on a scaleStandard Deviation 1.629
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL1.09 Points on a scaleStandard Deviation 1.514
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL3.14 Points on a scaleStandard Deviation 2.41
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL1.73 Points on a scaleStandard Deviation 1.679
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point from baseline (at the start of the double-blind phase) to Week 48.

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL2.76 Points on a scaleStandard Deviation 1.546
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL1.88 Points on a scaleStandard Deviation 2.088
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL2.70 Points on a scaleStandard Deviation 1.593
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL2.00 Points on a scaleStandard Deviation 2.21
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL1.79 Points on a scaleStandard Deviation 2.203
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL1.79 Points on a scaleStandard Deviation 2.366
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL2.90 Points on a scaleStandard Deviation 1.447
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL1.91 Points on a scaleStandard Deviation 2.05
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL1.60 Points on a scaleStandard Deviation 2.06
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL2.39 Points on a scaleStandard Deviation 2.831
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL3.09 Points on a scaleStandard Deviation 1.7
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL2.29 Points on a scaleStandard Deviation 2.616
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL2.17 Points on a scaleStandard Deviation 2.188
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL2.00 Points on a scaleStandard Deviation 2.045
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL2.05 Points on a scaleStandard Deviation 1.962
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL2.55 Points on a scaleStandard Deviation 2.162
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL3.36 Points on a scaleStandard Deviation 1.912
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL2.56 Points on a scaleStandard Deviation 2.77
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL1.88 Points on a scaleStandard Deviation 1.204
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL1.79 Points on a scaleStandard Deviation 1.228
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL1.83 Points on a scaleStandard Deviation 1.295
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL1.67 Points on a scaleStandard Deviation 1.188
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL2.06 Points on a scaleStandard Deviation 1.389
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL1.88 Points on a scaleStandard Deviation 1.258
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL2.22 Points on a scaleStandard Deviation 1.202
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL2.44 Points on a scaleStandard Deviation 1.13
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL2.11 Points on a scaleStandard Deviation 1.269
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL2.71 Points on a scaleStandard Deviation 2.812
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL1.25 Points on a scaleStandard Deviation 3.536
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL0.45 Points on a scaleStandard Deviation 2.583
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL2.57 Points on a scaleStandard Deviation 2.573
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL2.86 Points on a scaleStandard Deviation 2.41
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL0.64 Points on a scaleStandard Deviation 2.656
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL0.88 Points on a scaleStandard Deviation 3.399
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL1.38 Points on a scaleStandard Deviation 3.583
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL0.64 Points on a scaleStandard Deviation 2.58
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The DAS score of Dressing was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point from baseline (at the start of the double-blind phase) to Week 48. BTX was injected in participants up to 3 times from Week 12 to Week 36 when participants met re-injection criteria. Measurements were taken at each point until Week 48 and summarized by the number of weeks after the re-injection in individuals (4, 8, and 12 weeks after each injection) in open-label phase; thus, measurements could have been taken up to Week 48 (12 weeks after the Week 36 injection).

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.52 Points on a scaleStandard Deviation 0.755
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.45 Points on a scaleStandard Deviation 0.686
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.48 Points on a scaleStandard Deviation 0.68
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.40 Points on a scaleStandard Deviation 0.767
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.42 Points on a scaleStandard Deviation 0.763
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.46 Points on a scaleStandard Deviation 0.701
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.40 Points on a scaleStandard Deviation 0.681
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.42 Points on a scaleStandard Deviation 0.731
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.50 Points on a scaleStandard Deviation 0.749
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.30 Points on a scaleStandard Deviation 0.822
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.64 Points on a scaleStandard Deviation 0.809
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.35 Points on a scaleStandard Deviation 1.057
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.13 Points on a scaleStandard Deviation 0.815
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.55 Points on a scaleStandard Deviation 0.82
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.28 Points on a scaleStandard Deviation 1.018
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.39 Points on a scaleStandard Deviation 1.037
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.19 Points on a scaleStandard Deviation 0.873
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.45 Points on a scaleStandard Deviation 0.82
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.67 Points on a scaleStandard Deviation 0.5
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.67 Points on a scaleStandard Deviation 0.5
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.78 Points on a scaleStandard Deviation 0.441
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.50 Points on a scaleStandard Deviation 0.514
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.50 Points on a scaleStandard Deviation 0.514
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.63 Points on a scaleStandard Deviation 0.5
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.75 Points on a scaleStandard Deviation 0.447
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.81 Points on a scaleStandard Deviation 0.655
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.42 Points on a scaleStandard Deviation 0.507
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.57 Points on a scaleStandard Deviation 0.535
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.27 Points on a scaleStandard Deviation 0.467
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.36 Points on a scaleStandard Deviation 0.505
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.50 Points on a scaleStandard Deviation 0.535
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.50 Points on a scaleStandard Deviation 0.535
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.50 Points on a scaleStandard Deviation 0.535
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.43 Points on a scaleStandard Deviation 0.535
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.43 Points on a scaleStandard Deviation 0.535
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Dressing at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.36 Points on a scaleStandard Deviation 0.505
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The DAS score of Hygiene was assessed using a 4-point scale (0=No functional disability; 3=Severe disability) at each time point from baseline (at the start of the double-blind phase) to Week 48. BTX was injected in participants up to 3 times from Week 12 to Week 36 when participants met re-injection criteria. Measurements were taken at each point until Week 48 and summarized by the number of weeks after the re-injection in individuals (4, 8, and 12 weeks after each injection) in open-label phase; thus, measurements could have been taken up to Week 48 (12 weeks after the Week 36 injection).

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.55 Points on a scaleStandard Deviation 0.51
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.71 Points on a scaleStandard Deviation 0.644
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.65 Points on a scaleStandard Deviation 0.587
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.74 Points on a scaleStandard Deviation 0.78
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.45 Points on a scaleStandard Deviation 0.705
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.58 Points on a scaleStandard Deviation 0.731
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.67 Points on a scaleStandard Deviation 0.816
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.76 Points on a scaleStandard Deviation 0.781
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.53 Points on a scaleStandard Deviation 0.767
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.55 Points on a scaleStandard Deviation 0.522
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.83 Points on a scaleStandard Deviation 0.857
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.82 Points on a scaleStandard Deviation 0.883
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.55 Points on a scaleStandard Deviation 0.522
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.45 Points on a scaleStandard Deviation 0.522
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.83 Points on a scaleStandard Deviation 0.937
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.70 Points on a scaleStandard Deviation 0.974
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.62 Points on a scaleStandard Deviation 0.973
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.83 Points on a scaleStandard Deviation 0.857
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.61 Points on a scaleStandard Deviation 0.85
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.56 Points on a scaleStandard Deviation 0.726
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.88 Points on a scaleStandard Deviation 0.957
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.74 Points on a scaleStandard Deviation 0.806
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.61 Points on a scaleStandard Deviation 0.85
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.81 Points on a scaleStandard Deviation 0.981
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.56 Points on a scaleStandard Deviation 0.726
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.81 Points on a scaleStandard Deviation 0.981
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.22 Points on a scaleStandard Deviation 0.972
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.25 Points on a scaleStandard Deviation 0.463
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.55 Points on a scaleStandard Deviation 0.688
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.29 Points on a scaleStandard Deviation 0.488
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.29 Points on a scaleStandard Deviation 0.488
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.55 Points on a scaleStandard Deviation 0.688
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.14 Points on a scaleStandard Deviation 0.378
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.45 Points on a scaleStandard Deviation 0.688
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.38 Points on a scaleStandard Deviation 0.518
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Hygiene at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.38 Points on a scaleStandard Deviation 0.518
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The DAS score of Limb Posture was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point from baseline (at the start of the double-blind phase) to Week 48. BTX was injected in participants up to 3 times from Weeks 12 to 36 when participants met re-injection criteria. Measurements were taken at each point until Week 48 and summarized by the number of weeks after the re-injection in individuals (4, 8, and 12 weeks after each injection) in open-label phase; thus, measurements could have been taken up to Week 48 (12 weeks after the Week 36 injection).

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.81 Points on a scaleStandard Deviation 0.602
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.64 Points on a scaleStandard Deviation 0.742
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.70 Points on a scaleStandard Deviation 0.733
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.80 Points on a scaleStandard Deviation 0.677
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.67 Points on a scaleStandard Deviation 0.786
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.81 Points on a scaleStandard Deviation 0.764
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.80 Points on a scaleStandard Deviation 0.616
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.71 Points on a scaleStandard Deviation 0.719
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.84 Points on a scaleStandard Deviation 0.843
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.06 Points on a scaleStandard Deviation 0.639
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.00 Points on a scaleStandard Deviation 0.447
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.12 Points on a scaleStandard Deviation 0.6
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.74 Points on a scaleStandard Deviation 0.752
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.74 Points on a scaleStandard Deviation 0.619
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.67 Points on a scaleStandard Deviation 0.796
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.91 Points on a scaleStandard Deviation 0.539
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.00 Points on a scaleStandard Deviation 0.447
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.00 Points on a scaleStandard Deviation 0.767
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.00 Points on a scaleStandard Deviation 0.816
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.84 Points on a scaleStandard Deviation 0.834
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.89 Points on a scaleStandard Deviation 0.758
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.89 Points on a scaleStandard Deviation 0.832
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.88 Points on a scaleStandard Deviation 0.806
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.88 Points on a scaleStandard Deviation 0.806
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.89 Points on a scaleStandard Deviation 0.782
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.89 Points on a scaleStandard Deviation 0.782
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.89 Points on a scaleStandard Deviation 0.601
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.57 Points on a scaleStandard Deviation 0.787
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.75 Points on a scaleStandard Deviation 0.707
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.64 Points on a scaleStandard Deviation 0.674
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.71 Points on a scaleStandard Deviation 0.756
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.71 Points on a scaleStandard Deviation 0.756
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.73 Points on a scaleStandard Deviation 0.647
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.75 Points on a scaleStandard Deviation 0.707
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.75 Points on a scaleStandard Deviation 0.707
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Limb Posture at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.73 Points on a scaleStandard Deviation 0.647
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The DAS score of Pain was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point from baseline (at the start of the double-blind phase) to Week 48. BTX was injected in participants up to 3 times from Week 12 to Week 36 when participants met re-injection criteria. Measurements were taken at each point until Week 48 and summarized by the number of weeks after the re-injection in individuals (4, 8, and 12 weeks after each injection) in open-label phase; thus, measurements could have been taken up to Week 48 (12 weeks after the Week 36 injection).

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.21 Points on a scaleStandard Deviation 0.592
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.15 Points on a scaleStandard Deviation 0.508
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.05 Points on a scaleStandard Deviation 0.51
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.19 Points on a scaleStandard Deviation 0.594
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.21 Points on a scaleStandard Deviation 0.559
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.23 Points on a scaleStandard Deviation 0.527
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.10 Points on a scaleStandard Deviation 0.447
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.31 Points on a scaleStandard Deviation 0.718
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.14 Points on a scaleStandard Deviation 0.478
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.22 Points on a scaleStandard Deviation 0.428
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.29 Points on a scaleStandard Deviation 0.47
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.28 Points on a scaleStandard Deviation 0.461
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.22 Points on a scaleStandard Deviation 0.422
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.18 Points on a scaleStandard Deviation 0.405
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.09 Points on a scaleStandard Deviation 0.302
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.22 Points on a scaleStandard Deviation 0.422
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.18 Points on a scaleStandard Deviation 0.405
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.24 Points on a scaleStandard Deviation 0.436
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.31 Points on a scaleStandard Deviation 0.704
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.33 Points on a scaleStandard Deviation 0.707
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.16 Points on a scaleStandard Deviation 0.501
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.28 Points on a scaleStandard Deviation 0.669
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.28 Points on a scaleStandard Deviation 0.575
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.38 Points on a scaleStandard Deviation 0.719
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.31 Points on a scaleStandard Deviation 0.704
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.33 Points on a scaleStandard Deviation 0.707
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.33 Points on a scaleStandard Deviation 0.707
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL0.00 Points on a scaleStandard Deviation 0.535
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.14 Points on a scaleStandard Deviation 0.378
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.27 Points on a scaleStandard Deviation 0.467
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.29 Points on a scaleStandard Deviation 0.488
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.29 Points on a scaleStandard Deviation 0.488
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.18 Points on a scaleStandard Deviation 0.603
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.25 Points on a scaleStandard Deviation 0.463
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.13 Points on a scaleStandard Deviation 0.354
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Pain at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.27 Points on a scaleStandard Deviation 0.467
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

DAS scores of Hygiene, Pain, Dressing, and Limb posture were assessed using a 4-point scale (0=No functional disability to 3=Severe disability). Prior to the first injection, the investigator, in consultation with the participant, selected one functional disability item and assessed it as a principal measure at each time point from baseline (at the start of the double-blind phase) to Week 48.

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.00 Points on a scaleStandard Deviation 0.548
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.79 Points on a scaleStandard Deviation 0.74
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.90 Points on a scaleStandard Deviation 0.553
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.03 Points on a scaleStandard Deviation 0.707
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.74 Points on a scaleStandard Deviation 0.734
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.91 Points on a scaleStandard Deviation 0.718
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.00 Points on a scaleStandard Deviation 0.562
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.91 Points on a scaleStandard Deviation 0.712
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.95 Points on a scaleStandard Deviation 0.785
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.33 Points on a scaleStandard Deviation 0.686
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.18 Points on a scaleStandard Deviation 0.405
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.41 Points on a scaleStandard Deviation 0.618
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.96 Points on a scaleStandard Deviation 0.878
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.96 Points on a scaleStandard Deviation 0.878
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.86 Points on a scaleStandard Deviation 0.964
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.09 Points on a scaleStandard Deviation 0.539
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.18 Points on a scaleStandard Deviation 0.405
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.39 Points on a scaleStandard Deviation 0.698
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.31 Points on a scaleStandard Deviation 0.946
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.00 Points on a scaleStandard Deviation 0.882
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.11 Points on a scaleStandard Deviation 0.832
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-1.00 Points on a scaleStandard Deviation 0.767
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.25 Points on a scaleStandard Deviation 0.931
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.31 Points on a scaleStandard Deviation 0.873
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.11 Points on a scaleStandard Deviation 0.782
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.00 Points on a scaleStandard Deviation 0.866
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.00 Points on a scaleStandard Deviation 0.707
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-0.71 Points on a scaleStandard Deviation 0.756
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-0.88 Points on a scaleStandard Deviation 0.641
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.64 Points on a scaleStandard Deviation 0.674
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.86 Points on a scaleStandard Deviation 0.69
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-0.71 Points on a scaleStandard Deviation 0.756
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-0.73 Points on a scaleStandard Deviation 0.647
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.88 Points on a scaleStandard Deviation 0.641
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-0.88 Points on a scaleStandard Deviation 0.641
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the Disability Assessment Scale (DAS) Score of Principal Measure at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-0.64 Points on a scaleStandard Deviation 0.674
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The investigator assessed the MAS finger score using a 6-point scale (0, 1, 1+, 2, 3, and 4; 0=No increase in muscle tone to 4=Affected part\[s\] rigid in flexion or extension) at each time point from baseline (at the start of the double-blind phase) to week 48. The +1 (slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder \[less than half\] of ROM \[range of motion\]) of MAS score is regarded as score 1.5.

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.36 Points on a scaleStandard Deviation 0.744
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL0.89 Points on a scaleStandard Deviation 0.798
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.03 Points on a scaleStandard Deviation 0.803
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.40 Points on a scaleStandard Deviation 0.651
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.89 Points on a scaleStandard Deviation 0.668
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.14 Points on a scaleStandard Deviation 0.675
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.20 Points on a scaleStandard Deviation 0.696
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.06 Points on a scaleStandard Deviation 0.726
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.21 Points on a scaleStandard Deviation 0.648
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.33 Points on a scaleStandard Deviation 0.748
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.18 Points on a scaleStandard Deviation 0.751
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.12 Points on a scaleStandard Deviation 1.024
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.20 Points on a scaleStandard Deviation 0.938
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.22 Points on a scaleStandard Deviation 0.85
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.88 Points on a scaleStandard Deviation 0.757
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-0.95 Points on a scaleStandard Deviation 0.961
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.00 Points on a scaleStandard Deviation 1.072
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.53 Points on a scaleStandard Deviation 0.675
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.16 Points on a scaleStandard Deviation 0.724
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.26 Points on a scaleStandard Deviation 0.714
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.08 Points on a scaleStandard Deviation 0.974
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.92 Points on a scaleStandard Deviation 0.809
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.19 Points on a scaleStandard Deviation 0.772
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.00 Points on a scaleStandard Deviation 0.658
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.44 Points on a scaleStandard Deviation 0.95
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.28 Points on a scaleStandard Deviation 1.034
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.28 Points on a scaleStandard Deviation 0.87
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.43 Points on a scaleStandard Deviation 0.673
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.25 Points on a scaleStandard Deviation 0.463
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-0.77 Points on a scaleStandard Deviation 0.72
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.29 Points on a scaleStandard Deviation 0.699
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.36 Points on a scaleStandard Deviation 0.476
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.00 Points on a scaleStandard Deviation 0.742
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-0.88 Points on a scaleStandard Deviation 0.641
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.19 Points on a scaleStandard Deviation 0.704
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Finger Score From at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.32 Points on a scaleStandard Deviation 0.603
Secondary

Mean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label Phase

The investigator assessed the MAS wrist score using a 6-point scale (0, 1, 1+, 2, 3, and 4; 0=no increase in muscle tone to 4=affected part\[s\] rigid in flexion or extension) at each time point from baseline (at the start of the double-blind phase) to week 48. The +1 (slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder (\[less than half\] of ROM \[range of motion\]) of MAS score is regarded as score 1.5.

Time frame: Baseline; Weeks 4, 8, and 12 after each injection (up to Week 48; injections given from Week 12 to Week 36)

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.36 Points on a scaleStandard Deviation 0.551
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.53 Points on a scaleStandard Deviation 0.876
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.03 Points on a scaleStandard Deviation 0.856
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.61 Points on a scaleStandard Deviation 0.892
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.30 Points on a scaleStandard Deviation 0.927
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.18 Points on a scaleStandard Deviation 0.847
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.28 Points on a scaleStandard Deviation 0.786
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.41 Points on a scaleStandard Deviation 0.897
High-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-1.07 Points on a scaleStandard Deviation 0.894
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.53 Points on a scaleStandard Deviation 0.882
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.68 Points on a scaleStandard Deviation 0.405
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.29 Points on a scaleStandard Deviation 0.751
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.35 Points on a scaleStandard Deviation 0.922
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.30 Points on a scaleStandard Deviation 0.849
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-1.02 Points on a scaleStandard Deviation 0.858
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.64 Points on a scaleStandard Deviation 0.505
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.92 Points on a scaleStandard Deviation 0.943
High-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.36 Points on a scaleStandard Deviation 0.636
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.34 Points on a scaleStandard Deviation 0.747
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.53 Points on a scaleStandard Deviation 0.754
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.53 Points on a scaleStandard Deviation 0.831
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-1.11 Points on a scaleStandard Deviation 0.884
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.34 Points on a scaleStandard Deviation 0.79
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.09 Points on a scaleStandard Deviation 0.688
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.17 Points on a scaleStandard Deviation 0.829
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.28 Points on a scaleStandard Deviation 0.833
Low-Dose BTXMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.06 Points on a scaleStandard Deviation 0.768
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after third injection in OL-1.86 Points on a scaleStandard Deviation 0.69
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after second injection in OL-1.69 Points on a scaleStandard Deviation 0.53
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after first injection in OL-1.23 Points on a scaleStandard Deviation 0.984
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after third injection in OL-1.71 Points on a scaleStandard Deviation 0.488
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after third injection in OL-1.86 Points on a scaleStandard Deviation 0.627
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after first injection in OL-1.59 Points on a scaleStandard Deviation 0.801
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 12 after second injection in OL-1.25 Points on a scaleStandard Deviation 0.707
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 8 after second injection in OL-1.56 Points on a scaleStandard Deviation 0.563
Low-Dose PlaceboMean Change From Baseline (at the Start of the Double-blind Phase) in the MAS Wrist Score at 4, 8, and 12 Weeks After Each Injection in the Open-label PhaseWeek 4 after first injection in OL-1.41 Points on a scaleStandard Deviation 0.437
Secondary

Mean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind Phase

The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point in the double-blind phase.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 81.33 Points on a scaleStandard Deviation 1.95
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 41.80 Points on a scaleStandard Deviation 1.456
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 120.94 Points on a scaleStandard Deviation 1.949
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 61.61 Points on a scaleStandard Deviation 1.935
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 11.14 Points on a scaleStandard Deviation 1.132
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 60.54 Points on a scaleStandard Deviation 1.208
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 80.42 Points on a scaleStandard Deviation 1.139
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 120.32 Points on a scaleStandard Deviation 1.108
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 40.50 Points on a scaleStandard Deviation 1.175
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 10.31 Points on a scaleStandard Deviation 0.838
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 61.00 Points on a scaleStandard Deviation 1.049
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 10.86 Points on a scaleStandard Deviation 0.854
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 41.10 Points on a scaleStandard Deviation 1.044
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 80.86 Points on a scaleStandard Deviation 1.108
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 120.10 Points on a scaleStandard Deviation 1.3
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 80.27 Points on a scaleStandard Deviation 0.905
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 40.45 Points on a scaleStandard Deviation 0.82
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 10.91 Points on a scaleStandard Deviation 1.044
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 60.27 Points on a scaleStandard Deviation 0.905
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Investigator From Baseline to Week 12 of the Double-blind PhaseWeek 120.00 Points on a scaleStandard Deviation 0.894
Secondary

Mean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind Phase

The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point in the double-blind phase.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 81.52 Points on a scaleStandard Deviation 1.571
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 41.53 Points on a scaleStandard Deviation 1.793
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 121.32 Points on a scaleStandard Deviation 1.733
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 61.78 Points on a scaleStandard Deviation 1.918
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 11.14 Points on a scaleStandard Deviation 1.296
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 60.73 Points on a scaleStandard Deviation 1.614
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 80.54 Points on a scaleStandard Deviation 1.318
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 120.92 Points on a scaleStandard Deviation 1.956
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 40.65 Points on a scaleStandard Deviation 1.938
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 10.73 Points on a scaleStandard Deviation 1.343
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 61.24 Points on a scaleStandard Deviation 1.411
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 11.29 Points on a scaleStandard Deviation 1.231
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 41.48 Points on a scaleStandard Deviation 1.167
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 81.19 Points on a scaleStandard Deviation 1.25
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 120.90 Points on a scaleStandard Deviation 1.136
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 80.64 Points on a scaleStandard Deviation 2.461
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 40.45 Points on a scaleStandard Deviation 2.252
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 10.36 Points on a scaleStandard Deviation 1.12
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 60.55 Points on a scaleStandard Deviation 2.382
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Participant From Baseline to Week 12 of the Double-blind PhaseWeek 120.18 Points on a scaleStandard Deviation 2.442
Secondary

Mean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind Phase

The CGI score of functional disability was assessed at each visit using the 11-point Numeric Rating Scale (NRS) (-5=Worst Possible to 5=Best Possible) at each time point in the double-blind phase.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 61.29 Points on a scaleStandard Deviation 1.683
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 10.69 Points on a scaleStandard Deviation 0.86
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 80.98 Points on a scaleStandard Deviation 1.436
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 41.08 Points on a scaleStandard Deviation 1.51
High-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 120.74 Points on a scaleStandard Deviation 1.421
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 60.62 Points on a scaleStandard Deviation 1.061
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 40.62 Points on a scaleStandard Deviation 1.203
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 80.63 Points on a scaleStandard Deviation 0.97
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 10.46 Points on a scaleStandard Deviation 1.067
High-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 120.64 Points on a scaleStandard Deviation 0.995
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 120.62 Points on a scaleStandard Deviation 1.359
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 10.67 Points on a scaleStandard Deviation 0.73
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 40.86 Points on a scaleStandard Deviation 1.014
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 60.76 Points on a scaleStandard Deviation 1.3
Low-Dose BTXMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 80.71 Points on a scaleStandard Deviation 1.231
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 120.36 Points on a scaleStandard Deviation 1.433
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 80.45 Points on a scaleStandard Deviation 1.036
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 40.45 Points on a scaleStandard Deviation 0.934
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 10.36 Points on a scaleStandard Deviation 0.809
Low-Dose PlaceboMean Change From Baseline in Clinical Global Impression (CGI) Score of Functional Disability Assessed by the Physiotherapist/Occupational Therapist From Baseline to Week 12 of the Double-blind PhaseWeek 60.27 Points on a scaleStandard Deviation 0.647
Secondary

Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind Phase

DAS score of Dressing was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point in the double-blind phase.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.21 Points on a scaleStandard Deviation 0.713
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.24 Points on a scaleStandard Deviation 0.687
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.23 Points on a scaleStandard Deviation 0.633
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.27 Points on a scaleStandard Deviation 0.785
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.24 Points on a scaleStandard Deviation 0.586
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 60.04 Points on a scaleStandard Deviation 0.662
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 80.08 Points on a scaleStandard Deviation 0.717
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 120.12 Points on a scaleStandard Deviation 0.6
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 40.04 Points on a scaleStandard Deviation 0.662
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.04 Points on a scaleStandard Deviation 0.344
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.24 Points on a scaleStandard Deviation 0.436
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.24 Points on a scaleStandard Deviation 0.436
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.33 Points on a scaleStandard Deviation 0.483
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.38 Points on a scaleStandard Deviation 0.498
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.24 Points on a scaleStandard Deviation 0.436
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.09 Points on a scaleStandard Deviation 0.302
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 40.00 Points on a scaleStandard Deviation 0
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 10.00 Points on a scaleStandard Deviation 0
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.09 Points on a scaleStandard Deviation 0.302
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Dressing From Baseline to Week 12 of the Double-blind PhaseWeek 120.00 Points on a scaleStandard Deviation 0
Secondary

Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind Phase

DAS score of Hygiene was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point in double-blind phase.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 8-0.40 Points on a scaleStandard Deviation 0.676
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 4-0.39 Points on a scaleStandard Deviation 0.603
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 12-0.34 Points on a scaleStandard Deviation 0.6
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 6-0.43 Points on a scaleStandard Deviation 0.612
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 1-0.27 Points on a scaleStandard Deviation 0.532
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 6-0.31 Points on a scaleStandard Deviation 0.618
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 8-0.29 Points on a scaleStandard Deviation 0.624
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 12-0.28 Points on a scaleStandard Deviation 0.678
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 4-0.23 Points on a scaleStandard Deviation 0.587
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 1-0.12 Points on a scaleStandard Deviation 0.431
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 6-0.43 Points on a scaleStandard Deviation 0.746
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 1-0.43 Points on a scaleStandard Deviation 0.746
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 4-0.38 Points on a scaleStandard Deviation 0.669
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 8-0.43 Points on a scaleStandard Deviation 0.746
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 12-0.33 Points on a scaleStandard Deviation 0.658
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 8-0.18 Points on a scaleStandard Deviation 0.405
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 4-0.36 Points on a scaleStandard Deviation 0.674
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 1-0.18 Points on a scaleStandard Deviation 0.405
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 6-0.27 Points on a scaleStandard Deviation 0.467
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Hygiene From Baseline to week12 of the Double-blind PhaseWeek 12-0.09 Points on a scaleStandard Deviation 0.539
Secondary

Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind Phase

DAS score of Limb Posture was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point in the double-blind phase.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.67 Points on a scaleStandard Deviation 0.694
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.62 Points on a scaleStandard Deviation 0.602
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.57 Points on a scaleStandard Deviation 0.651
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.69 Points on a scaleStandard Deviation 0.683
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.43 Points on a scaleStandard Deviation 0.539
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.15 Points on a scaleStandard Deviation 0.464
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.21 Points on a scaleStandard Deviation 0.509
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.16 Points on a scaleStandard Deviation 0.473
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.12 Points on a scaleStandard Deviation 0.326
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.15 Points on a scaleStandard Deviation 0.368
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.67 Points on a scaleStandard Deviation 0.796
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.33 Points on a scaleStandard Deviation 0.483
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.48 Points on a scaleStandard Deviation 0.602
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.52 Points on a scaleStandard Deviation 0.68
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.43 Points on a scaleStandard Deviation 0.811
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 80.00 Points on a scaleStandard Deviation 0.447
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.09 Points on a scaleStandard Deviation 0.302
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.09 Points on a scaleStandard Deviation 0.302
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.09 Points on a scaleStandard Deviation 0.302
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Limb Posture From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.09 Points on a scaleStandard Deviation 0.539
Secondary

Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind Phase

DAS score of pain was assessed using a 4-point scale (0=No functional disability to 3=Severe disability) at each time point in the double-blind phase.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.19 Points on a scaleStandard Deviation 0.673
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.20 Points on a scaleStandard Deviation 0.749
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.09 Points on a scaleStandard Deviation 0.747
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.20 Points on a scaleStandard Deviation 0.676
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.10 Points on a scaleStandard Deviation 0.608
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.12 Points on a scaleStandard Deviation 0.588
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.04 Points on a scaleStandard Deviation 0.751
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 120.00 Points on a scaleStandard Deviation 0.645
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 40.04 Points on a scaleStandard Deviation 0.445
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 10.04 Points on a scaleStandard Deviation 0.344
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.10 Points on a scaleStandard Deviation 0.436
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.14 Points on a scaleStandard Deviation 0.359
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.10 Points on a scaleStandard Deviation 0.436
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.14 Points on a scaleStandard Deviation 0.478
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.14 Points on a scaleStandard Deviation 0.359
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.09 Points on a scaleStandard Deviation 0.302
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 40.00 Points on a scaleStandard Deviation 0
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 10.00 Points on a scaleStandard Deviation 0
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.09 Points on a scaleStandard Deviation 0.302
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Pain From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.18 Points on a scaleStandard Deviation 0.405
Secondary

Mean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind Phase

DAS scores of Hygiene, Pain, Dressing, and Limb posture were assessed using a 4-point scale (0=No functional disability to 3=Severe disability). Prior to the first injection, the investigator, in consultation with the participant, selected one functional disability item and assessed it as a principal measure at each time point in the double-blind phase.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.86 Points on a scaleStandard Deviation 0.764
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.79 Points on a scaleStandard Deviation 0.771
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.49 Points on a scaleStandard Deviation 0.612
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.82 Points on a scaleStandard Deviation 0.748
High-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.70 Points on a scaleStandard Deviation 0.689
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.35 Points on a scaleStandard Deviation 0.629
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.38 Points on a scaleStandard Deviation 0.647
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.31 Points on a scaleStandard Deviation 0.618
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.15 Points on a scaleStandard Deviation 0.368
High-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.32 Points on a scaleStandard Deviation 0.557
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.67 Points on a scaleStandard Deviation 0.577
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.67 Points on a scaleStandard Deviation 0.658
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.67 Points on a scaleStandard Deviation 0.577
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.71 Points on a scaleStandard Deviation 0.561
Low-Dose BTXMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.57 Points on a scaleStandard Deviation 0.598
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 80.00 Points on a scaleStandard Deviation 0.447
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 40.00 Points on a scaleStandard Deviation 0
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 10.00 Points on a scaleStandard Deviation 0
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.09 Points on a scaleStandard Deviation 0.302
Low-Dose PlaceboMean Change From Baseline in Disability Assessment Scale (DAS) Score of Principal Measure From Baseline to Week 12 of the Double-blind PhaseWeek 120.09 Points on a scaleStandard Deviation 0.302
Secondary

Mean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind Phase

The investigator assessed MAS finger score using a 6-point scale (0, 1, 1+, 2, 3, and 4; 0=No increase in muscle tone to 4=Affected part\[s\] rigid in flexion or extension) at each time point in the double-blind phase. The +1 (slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder \[less than half\] of ROM \[range of motion\]) of MAS score is regarded as score 1.5.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.97 Points on a scaleStandard Deviation 0.8
High-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.86 Points on a scaleStandard Deviation 0.79
High-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.67 Points on a scaleStandard Deviation 0.709
High-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.92 Points on a scaleStandard Deviation 0.821
High-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.60 Points on a scaleStandard Deviation 0.671
High-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.37 Points on a scaleStandard Deviation 0.657
High-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.33 Points on a scaleStandard Deviation 0.734
High-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.19 Points on a scaleStandard Deviation 0.402
High-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.35 Points on a scaleStandard Deviation 0.759
High-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.26 Points on a scaleStandard Deviation 0.597
Low-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.45 Points on a scaleStandard Deviation 0.947
Low-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.69 Points on a scaleStandard Deviation 0.733
Low-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.95 Points on a scaleStandard Deviation 0.757
Low-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.98 Points on a scaleStandard Deviation 0.782
Low-Dose BTXMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.69 Points on a scaleStandard Deviation 0.75
Low-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.23 Points on a scaleStandard Deviation 0.684
Low-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.27 Points on a scaleStandard Deviation 0.518
Low-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.23 Points on a scaleStandard Deviation 0.684
Low-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.14 Points on a scaleStandard Deviation 0.323
Low-Dose PlaceboMean Change From Baseline in MAS Finger Score From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.55 Points on a scaleStandard Deviation 0.688
Secondary

Mean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind Phase

The investigator assessed MAS wrist score using a 6-point scale (0, 1, 1+, 2, 3, and 4; 0=No increase in muscle tone to 4=Affected part\[s\] rigid in flexion or extension) at each time point in the double-blind phase. The +1 (slight increase in muscle tone, manifested by a catch, followed by minimal resistance throughout the remainder \[less than half\] of ROM \[range of motion\]) of MAS score is regarded as score 1.5.

Time frame: Baseline; Weeks 1, 4, 6, 8, and 12

Population: Full Analysis Set (FAS): all participants randomized, with the exception of those who did not receive any investigational product and those with no assessment of post-treatment MAS wrist score

ArmMeasureGroupValue (MEAN)Dispersion
High-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 4-1.05 Points on a scaleStandard Deviation 0.912
High-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.66 Points on a scaleStandard Deviation 0.745
High-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 6-1.15 Points on a scaleStandard Deviation 0.931
High-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.83 Points on a scaleStandard Deviation 0.842
High-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 8-1.01 Points on a scaleStandard Deviation 0.97
High-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.29 Points on a scaleStandard Deviation 0.569
High-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.23 Points on a scaleStandard Deviation 0.43
High-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.48 Points on a scaleStandard Deviation 0.671
High-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.35 Points on a scaleStandard Deviation 0.599
High-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.20 Points on a scaleStandard Deviation 0.408
Low-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.95 Points on a scaleStandard Deviation 0.789
Low-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.86 Points on a scaleStandard Deviation 0.777
Low-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.71 Points on a scaleStandard Deviation 0.845
Low-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.93 Points on a scaleStandard Deviation 0.884
Low-Dose BTXMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.88 Points on a scaleStandard Deviation 0.74
Low-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 8-0.50 Points on a scaleStandard Deviation 0.742
Low-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 6-0.68 Points on a scaleStandard Deviation 0.956
Low-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 1-0.50 Points on a scaleStandard Deviation 0.742
Low-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 12-0.27 Points on a scaleStandard Deviation 0.647
Low-Dose PlaceboMean Change From Baseline in MAS Wrist Score From Baseline to Week 12 of the Double-blind PhaseWeek 4-0.73 Points on a scaleStandard Deviation 1.009

Source: ClinicalTrials.gov · Data processed: Mar 31, 2026