Transdermal clonidine patch use in the management of childhood hypertonia: a cross-sectional UK-wide service evaluation
Data were available for 259 CAYP from 11 services, with 176/259 (68%) under active follow-up. Median age at starting TCPs was 8.6 years (25th to 75th centile 5.2-12 years). Gross Motor Function Classification System level (or equivalent) was V for 206/253 (81.4%) CAYP. Clinically significant chorea was observed in 33/255 (12.9%), spasticity in 116/254 (45.7%) and dystonia in 234/256 (91.4%) CAYP. The most common reasons for TCP initiation were overall dystonia severity (61/259, 23.6%), concerns about absorption of enteral medication (54/259, 20.8%) and excess sedation with enteral clonidine (46/259, 17.8%). TCP use had been discontinued by 61/259 (23.6%) CAYP, most commonly because of skin rash (24/259, 9.3%). The median time to discontinuing patches was 3.5 months. In addition to TCPs, 148/259 (57.1%) of CAYP continued with enteral clonidine. Additional tone-reducing medication use ranged from 0 to 6 additional medications (modal number of medications 3), CONCLUSION: We present the first UK-based multicentre evaluation of TCP use in CAYP with motor disorders, highlighting the complexity of the medical problems of these CAYP and their clinical management. TCPs appear generally to be tolerated by CAYP, but further work is required to establish their efficacy.
Authors
- Rajib Lodh (ORCID: https://orcid.org/0000-0001-5482-4759)
- Daniel Edward Lumsden (ORCID: https://orcid.org/0000-0002-5524-6177)
- Lucinda Carr (ORCID: https://orcid.org/0000-0001-9238-108X)
- Manju A. Kurian (ORCID: https://orcid.org/0000-0003-3529-5075)
- Sofia Marques (ORCID: https://orcid.org/0000-0002-9474-5972)
- Y de Alwis
- Karen S. Pysden (ORCID: https://orcid.org/0000-0003-0443-5784)
- Mayy El Gamal
- Jean‐Pierre Lin (ORCID: https://orcid.org/0000-0001-9314-2259)
- Anita Devlin (ORCID: https://orcid.org/0000-0002-3814-4777)
- Todd Smallbone
- Sarah Abernethy
- Emily Harrop (ORCID: https://orcid.org/0000-0002-2480-2062)
- Claire Teresa Lundy (ORCID: https://orcid.org/0000-0001-9657-353X)
- Robert Spaull (ORCID: https://orcid.org/0000-0003-4096-6945)
- Santosh Mordekar (ORCID: https://orcid.org/0000-0002-6135-1969)
- Katharine Forrest
- Louisa Akwaama Lemaire (ORCID: https://orcid.org/0009-0007-9903-2369)
- Valerie Orr
Institutions
- Belfast Health and Social Care Trust (GB)
- Leeds General Infirmary (GB)
- Guy's and St Thomas' NHS Foundation Trust (GB)
- Great Ormond Street Hospital (GB)
- Royal Hospital for Children (GB)
- University Hospitals Bristol NHS Foundation Trust (GB)
- Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
- Bristol Royal Hospital for Children (GB)
- Sheffield Children's NHS Foundation Trust (GB)
- Institute of Child Health (IN)
- Great North Children's Hospital (GB)
- Evelina London Children's Healthcare (GB)
- Oxford University Hospitals NHS Trust (GB)
- Bradford Teaching Hospitals NHS Foundation Trust (GB)
- University Hospitals Bristol and Weston NHS Foundation Trust (GB)
- University College London (GB)
- Newcastle University (GB)
Publication Details
- Journal
- Archives of Disease in Childhood
- Published
- 2025-11-11
- DOI
- https://doi.org/10.1136/archdischild-2025-329648
- Citations
- 1
- Primary Topic
- Gastrointestinal motility and disorders
- Type
- article
- Field-Weighted Citation Impact
- 1.81