Abstract Details

Title Clinical Characteristics that Impact OnabotulinumtoxinA Treatment Adherence in Patients with Spasticity from the ASPIRE Study

Topic Neuro-rehabilitation

Presentation(s) S42 - Neuro-rehabilitation (4:18 PM-4:30 PM)

Poster/Presentation
Number 005

Objective We aimed to identify patient demographics and clinical characteristics that impact onabotulinumtoxinA treatment adherence from the Adult Spasticity International Registry (ASPIRE) study.

Background A better understanding of factors that impact onabotulinumtoxinA treatment adherence can help improve clinical strategies to manage spasticity.

Design/Methods Multicenter, international, prospective, observational registry (NCT01930786). Adult patients with spasticity were treated with onabotulinumtoxinA at their clinician’s discretion over 2 years. Clinically meaningful thresholds for treatment adherence/non-adherence were used. Treatment adherent: patients receiving ≥3 treatment sessions with onabotulinumtoxinA during the 2-year period; non-adherent: patients receiving ≤2 treatment sessions. Data were assessed using univariate logistic regression and are presented as odds ratios (OR) with 95% confidence intervals (CI). Statistical significance, P<0.05; non-significant effects of clinical interest, P<0.10.

Results Of the total population in ASPIRE (N=730), 523 patients (71.6%) were categorized as treatment adherent and 207 patients (28.4%) as non-adherent. On average, adherent patients received 5.3 (SD:1.6) treatment sessions, non-adherent patients received 1.5 (SD:0.5). Patients with traumatic brain injury (TBI; 57.8%) were less likely to adhere to treatment (72.6% other etiologies; OR:0.52, CI:0.28-0.96; P=0.036), while patients with cerebral palsy (80.5%) trended towards more likely to adhere (70.6% other etiologies; OR:1.72, CI:0.96-3.10; P=0.070). Additionally, patients who used orthotics (74.3% vs. 68.3% absence; OR:1.34, CI:0.96-1.86; P=0.081) or had surgeries/procedures (79.6% vs. 70.3% absence; OR:1.65, CI:0.97-2.81; P=0.067) trended towards more likely to adhere. Conversely, patients naïve to botulinum toxins for spasticity (63.6%) were less likely to adhere than non-naïve patients (76.4%; OR:0.54, CI:0.39-0.75; P<0.001) and diabetic patients (62.8%) were less likely to adhere than non-diabetic patients (73.0%; OR:0.62, CI:0.40-0.98; P=0.042).

Conclusions Additional analysis from ASPIRE suggests that TBI patients, diabetic patients, and those naïve to botulinum toxins for spasticity are at higher risk of treatment non-adherence. Further analysis of risk factors that impact onabotulinumtoxinA treatment adherence can optimize spasticity management strategies to improve long-term patient care.

Authors/Disclosures
Alberto Esquenazi, MD (Department of Physical Medicine and Rehabilitation) PRESENTER	Dr. Esquenazi has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Ipsen and Allergan. Dr. Esquenazi has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Ipsen and Allergan. The institution of Dr. Esquenazi has received research support from Ipsen, Allergan and Merz.
Wayne W. Feng, MD, FAAN (Duke University School of Medicine)	Dr. Feng has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Namsa. The institution of Dr. Feng has received research support from NIH. The institution of Dr. Feng has received research support from American heart association . The institution of Dr. Feng has received research support from Ipsen.
George F. Wittenberg, MD, PhD (University of Pittsburgh SOM)	The institution of Dr. Wittenberg has received research support from Deptment of Veterans Affairs.
	No disclosure on file
	No disclosure on file
Kristina M. Fanning, PhD (MIST Reserach)	The institution of Dr. Fanning has received research support from Abbvie. The institution of Dr. Fanning has received research support from NYC Langone Health . The institution of Dr. Fanning has received research support from Uiversity of SC - Irvine. The institution of Dr. Fanning has received research support from AESARA.
Aleksej Zuzek, PhD (Allergan)	Dr. Zuzek has received personal compensation for serving as an employee of AbbVie Inc.. Dr. Zuzek has stock in AbbVie Inc..
	No disclosure on file
Daniel Bandari, MD (MS Center of California)	No disclosure on file

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