Disclosures: Richard D. Zorowitz, MD, FAAPMR, FAHA: Ipsen Pharmaceuticals (Products/Services: Yes) (Research Grant or Support)

Background and/or Objectives: To describe real-world abobotulinumtoxinA (aboBoNT-A) injection patterns for patients presenting for treatment of lower limb spasticity.

Design: AboLiSh is a prospective, longitudinal, observational study (NCT04050527) exploring the real-world utilization and effectiveness of aboBoNT-A for lower limb spasticity.

Setting: International specialist centers across 9 countries.

Participants: Adult patients (≥18 years old) with unilateral adult lower limb spasticity and able to take ≥5 steps (with or without assistance).

Interventions: Patients are treated with aboBoNT-A in accordance with local prescribing guidelines to achieve individualized treatment goals.

Main Outcome Measures: We report key aboBoNT-A injection parameters at baseline, including muscles selected for injection, doses per muscle, and use and type of injection guidance techniques.

Results: The baseline population includes 421 adults with lower limb spasticity, from 45 sites in 9 countries (mean±SD age 53.7±13.9 years; 65.1% male). Most (96.4%) have spasticity due to acquired brain injury (stroke/trauma). The median total injected dose of aboBoNT-A was 600U [range 100-1500U], which was injected into a median of 4 muscles [1-8] with most injections given under guidance (74.0%; EMG 41.0%, electrostimulation 32.3%, ultrasound 42.9%). The most commonly injected lower limb muscles (>20% patients) were: gastrocnemius medial head (injected in 82.7% of patients, median dose 150U), gastrocnemius lateral head (71.7%, 150U), soleus (66.5%, 200U), tibialis posterior (49.6%, 150U), flexor digitorum longus (39.0%, 100U), and flexor hallucis longus (22.1%, 100U). For these muscles, use of injection guidance ranged from 71.6% for the gastrocnemius medial head to 79.9% for the flexor digitorum longus. While there was significant variation, the modal aboBoNT-A dilution was 200U/mL.

Conclusions: In these baseline analyses, six muscles were identified as being most frequently injected for lower limb spasticity. Injection practice was consistent with foot equinus and/or varus as the most common pattern of lower limb spasticity treated, consistent with a key goal of improving mobility.

Level of Evidence: Level II

« Back to AAPM&R Annual Assembly 2022

PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/which-are-the-most-frequently-injected-muscles-in-patients-undergoing-treatment-with-abobotulinumtoxina-for-lower-limb-spasticity-in-routine-practice-baseline-data-from-the-abolish-study/