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

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.

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.

Eligibility Criteria:
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).