Disclosures: Ganesh Bavikatte, MD: Allergan (Products/Services: No) (Research Grant or Support, Speaker/Honoraria includes speakers bureau, symposia, and expert witness)Ipsen (Products/Services: No) (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received, Speaker/Honoraria includes speakers bureau, symposia, and expert witness)Merz (Products/Services: No) (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received, Speaker/Honoraria includes speakers bureau, symposia, and expert witness)

Objective: Examine onabotulinumtoxinA utilization in patients with upper limb (UL) and lower limb (LL) spasticity from the Adult Spasticity International Registry (ASPIRE) study to gain real-world insights into the treatment of spastic hemiparesis.

Design: 2-year, multicenter, observational registry (NCT01930786).Setting : International clinical sites.Participants : Adults with spasticity.

Interventions: OnabotulinumtoxinA at clinician’s discretion.

Main Outcome Measures: OnabotulinumtoxinA utilization and safety data were collected at each treatment session. Patients with spastic hemiparesis included those that received ≥1 UL treatment and ≥1 LL treatment during the 2-year study.

Results: Of N&#3f730 patients in ASPIRE, n=284 patients were defined as hemiparetic, with n=275 patients treated for the UL and LL at the same treatment session (n=275 described hereafter). Hemiparetic patients were on average 53.2 years old, 51.3% male, 68.0% Caucasian, 39.3% naïve to botulinum toxin for spasticity, and 72.7% post-stroke. The mean total dose of onabotulinumtoxinA was 477 U for UL+LL, 257 U for UL, and 220 U for LL. Of the hemiparetic patients, 56% had a treatment interval of 10-15 weeks, 62% had 5-15 injections/session, and 82% had >5 muscles injected/session. Clenched fist was the most common UL presentation (n=219 patients), with 55% of sessions to the left side only. Equinovarus foot was the most common LL presentation (n=238 patients), with 52% of sessions to the left side only. 94 patients (34.2%) reported 293 non-serious adverse events (AEs); 9 AEs in 9 patients (3.3%) were considered treatment-related. 42 patients (15.3%) reported 80 serious AEs; 3 serious AEs in 2 patients (0.7%) were considered treatment-related. No new safety signals were identified.Conclusions: This ASPIRE analysis provides valuable, real-world evidence on the use of onabotulinumtoxinA to treat patients with spastic hemiparesis, with onabotulinumtoxinA most frequently utilized to treat clenched fist (UL) and equinovarus foot (LL).

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/onabotulinumtoxina-treatment-in-patients-with-upper-limb-and-lower-limb-spasticity-from-the-aspire-study/