Objective: Identify baseline clinical characteristics and treatment-related factors that impact adherence to onabotulinumtoxinA (onabotA) treatment in post-stroke and multiple sclerosis (MS) patients from the Adult Spasticity International Registry (ASPIRE) study.

Background: An increased knowledge of factors that impact onabotA treatment adherence can help improve spasticity management strategies.

Method: International, prospective registry (NCT01930786). Patients treated with onabotA for spasticity at clinician’s discretion. Clinically meaningful thresholds for treatment adherence (≥3 treatment sessions in 2-year study)/non-adherence (≤2 sessions) used. Data analyzed using logistic regression; presented as odds ratios (OR) with 95% confidence intervals (CI). Statistical significance accepted at P<0.05.Treatment-related factors shown for sessions 1 and 2 only.

Results: In the final stroke model (N=346/411), 288 patients (83.2%) were categorized as treatment adherent, with 5.3(±1.6[mean±SD]) sessions, and 58 (16.8%) non-adherent, with 2.0(±0.0). Mean(SD) treatment interval (session 1 to 2) was 18.1(8.5) weeks in adherent and 23.6(16.0) in non-adherent. Baseline characteristics associated with adherence: European patient (OR:2.91;CI:1.35-6.27;P=0.006) and use of orthotics (OR:3.12;CI:1.54-6.34;P=0.002). Treatment-related risk factors for non-adherence: treatment interval ≥15 weeks (session 1 to 2; OR:0.42;CI:0.21-0.84;P=0.014) and moderate/severe disability on upper limb Disability Assessment Scale pain subscale (OR:0.39;CI:0.19-0.82;P=0.013). In the final MS model (n=105/119), 92 patients (87.6%) were categorized as treatment adherent, with 5.4(±1.6) sessions, and 13 (12.4%) non-adherent, with 2.0(±0.0). Mean(SD) treatment interval (session 1 to 2) was 17.7(8.9) weeks in adherent and 25.6(17.8) in non-adherent. Treatment for stiff extended knee (OR:9.68;CI:1.68-55.80;P=0.011) was associated with adherence, while treatment for equinovarus foot (OR:0.07;CI:0.01-0.57;P=0.012) and treatment interval ≥15
weeks (session 1 to 2; OR:0.11;CI:0.02-0.76;P=0.025) were treatment-related risk factors for non-adherence.

Conclusion: These preliminary analyses from ASPIRE provide real-world insights to improve adherence, and decrease non-adherence, to onabotA treatment for spasticity to enhance patient care.

« Back to MDS Virtual Congress 2020

MDS Abstracts - https://www.mdsabstracts.org/abstract/identification-of-factors-that-impact-adherence-to-onabotulinumtoxina-treatment-for-spasticity-in-post-stroke-and-multiple-sclerosis-patients-from-aspire/