Disclosures: David N. Bowers, MD, FACP: Ipsen (Products/Services: Yes) (Consultant/Advisory Board, Research Grant or Support, Speaker/Honoraria includes speakers bureau, symposia, and expert witness)

Objective: To evaluate the cost effect of switching from Onabotulinum Toxin A (Botox) to abobotulinum Toxin A (Dysport); to evaluate tolerability to abobotulinum Toxin A (Dysport); after transitioning from Onabotulinum Toxin A (Botox); and to evaluate patient satisfaction to treatment.

Design: Cost-utility analysis (or cost-effectiveness analysis?) with evaluation of patient-reported responses to perceived benefits. Setting : Single center clinical outpatient Physical Medicine and Rehabilitation office Participants : We examined 34 patients under treatment for spasticity in consecutive sessions and followed them for a minimum of five years.

Interventions: Information was abstracted from all qualifying medical records of 34 patients with recorded office visits for treatment of spasticity. These patients transitioned from Onabotulinum Toxin A (Botox) to Abobotulinum Toxin A (Dysport) during 2012-2013 and followed for up to five years.

Main Outcome Measures: The main outcome measures of our study were three-pronged: evaluating the cost effect, tolerability and patient satisfaction of switching from Onabotulinum Toxin A to Anobotulinum Toxin A

Results: We found the Abo/Ona ratio to average 2.71:1 with significantly lower costs ( a reduction of 31%) associated with Abobotulinum Toxin A use. Primary results revealed no difference in reported weakness or other adverse effects. Secondary results indicated that age may influence patient responses. Reports of weakness from toxin injections increased with age, report of relief from spasticity increased with age and splint toleration decreased with age. Patient satisfaction with the clinical outcome following the switch to Abobotulinum Toxin A remained stable. Conclusions: Clinical decisions regarding the choice of Abobotulinum Toxin A or Onobotulinum Toxin A should be made independently of dose-conversion factors, that Onabotulinum Toxin A and Abobotulinum Toxin A can be used interchangeably in the treatment of upper and lower extremity spasticity, and there is an approximate lower cost of 31% with the use of Anobotulinum toxin A without compromise of outcomes or patient satisfaction.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/a-retrospective-analysis-evaluating-a-switch-of-abobotulinumtoxina-for-the-treatment-of-adult-spasticity-in-patients-previously-treated-with-onabotulinumtoxina/