Objective: Evaluate differences in the botulinum neurotoxin type A (BoNT-A) treatment experience between patients with cervical dystonia (CD) treated in the United States (US) versus Europe (EU).

Background: US and EU guidelines recommend injections of BoNT-A as 1^st line treatment for CD. However, regional differences in clinical practice may impact the patient experience.

Method: Online patient survey to capture the treatment experiences of adults with CD. Eligible respondents had ≥2 previous BoNT-A treatments. The survey was deployed in the US & EU (Italy, France, Germany and United Kingdom). Only descriptive analyses were performed.

Results: Data from 209 respondents (US=97, EU=112) were analyzed. Mean age was 49.3 years in US & 50.1 years in EU; 82% & 79% respondents were female, respectively. Respondents reported having their first symptoms at a mean age of 41.6 years in US & 38.0 years in EU. They received their 1^st BoNT-A injection within a mean [95%CI] of 0.7 [0.5-0.9] years of diagnosis in US & 1.3 [0.5-2.0] years in EU.  US respondents were more likely to receive additional oral medications than those in EU (38 vs 24%) and less likely to receive physiotherapy (26 vs 36%). Respondents in both regions generally received their injections in 3-4 month intervals (72 in US vs 67% in EU). Whereas more US respondents treated have their injections scheduled according to individual symptoms (29 vs 21% in EU), more EU respondents said their injection schedule is dependent on doctor availability (20 vs 6% in US). Symptom re-emergence between injections was common (87–88%), with significant impact on quality of life. Working respondents in US were more likely to report ‘work inefficiency’ (72 vs 60% in EU), while more EU respondents said they had ‘reduced working’ (31 vs 18% in US). Whereas more US respondents said they got a prescription of an additional treatment (39 vs 30%) or were asked to come earlier for their next injection (27 vs. 19%), most EU patients said they had their dose increased at the next session (61 vs 48% in US).

Conclusion: Symptom re-emergence was common across both regions with significant impact on patient quality of life. There were subtle numerical differences in the way CD is managed with BoNT-A between US vs. EU but inconclusive without statistical differences analysis.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/patient-experiences-of-cervical-dystonia-management-with-botulinum-toxin-a-a-comparison-of-us-versus-european-survey-findings/