Objective: Investigate factors influencing satisfaction with botulinum toxin-A (BoNT-A) treatment in patients with cervical dystonia (CD) who have been treated for 1 year.

Background: Little is known about what influences patient satisfaction in CD patients who are on an established, repeat treatment regimen with BoNT-A.

Methods: INTEREST IN CD2 (NCT01753349) is an observational, routine-practice study following patients with CD treated with BoNT-A. Stepwise logistic regression analyses were used to evaluate potential predictors for treatment satisfaction in subjects (N=819) who had received repeat BoNT-A treatment over 1-year (i.e. satisfaction with the treatment cycle closest to the 1-year time point). Satisfaction was assessed in 2 ways: (1) ‘Today satisfaction’, where subjects rated their current satisfaction (end of treatment cycle), (2) ‘Highest satisfaction’, where subjects rated their highest level of satisfaction over the previous cycle. In each analysis: Step 1 was a univariate logistic regression analysis of baseline factors; Step 2 assessed the factors retained as potentially predictive for satisfaction in Step 1 (with p<0.2); Step 3 was a multivariate stepwise logistic regression analysis of the factors retained after Step 2.

Results: Of the 35 potential baseline factors, higher TWSTRS-Total score was the only factor associated in the multivariate analysis with lower ‘Highest’ satisfaction (OR [95%CI]=0.978 [0.962; 0.994]; p=0.0071) and was also associated with lower ‘Today’ satisfaction (OR [95%CI]=0.981 [0.970; 0.992]; 0.0011). Other significant predictors for poorer ‘Today’ satisfaction per the multiple regression included a longer duration of disease (≤1 vs 1-5 years; OR=1.805 [1.046; 3.171]; p=0.0363), family history of CD (OR=0.495 [0.261; 0.919]; p=0.0279) and use of BoNT-A for a non-CD indication (OR=0.268 [0.085; 0.715]; p=0.0134). Use of electromyography in ≥1 muscle improved the likelihood of satisfaction with treatment (OR=1.521 (1.099; 2.113); p=0.0119).

Conclusions: Subjects with more severe CD (higher TWSTRS-Total scores) are less likely to be satisfied with established BoNT-A treatment. Likewise, patients with a family history or requiring treatment for other indications (e.g. other dystonias), who often have a more severe presentation, are also less likely to be satisfied with their CD symptom control treatment at the end of a BoNT-A treatment cycle.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/factors-predicting-patient-satisfaction-with-botulinum-toxin-treatment-in-cervical-dystonia-patients-who-have-been-treated-for-a-year/