Session Information
Date: Saturday, November 16, 2019
Session Title: General Rehabilitation Case & Research Report
Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 1
Disclosures: Alberto Esquenazi, MD, FAAPMR: Ipsen: Research Grant or Support
Objective: To identify patient demographics and clinical characteristics that impact onabotulinumtoxinA treatment adherence from the Adult Spasticity International Registry (ASPIRE) study.
Design: Prospective, observational registry (NCT01930786) over 2 years.
Setting: International clinical sites.
Participants: Adult patients with focal spasticity across multiple etiologies.
Interventions: OnabotulinumtoxinA at the clinician’s discretion.
Main Outcome Measures: A clinically meaningful threshold for treatment adherence was used for this analysis. Treatment adherent was defined as patients receiving ≥3 treatment sessions with onabotulinumtoxinA during the 2-year period; non-adherent was defined as patients receiving ≤2 treatment sessions. Patient demographics and clinical characteristics were assessed using univariate logistic regression. Data are presented as odds ratios (OR) with 95% confidence intervals (CI).
Results: Of the total patient 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 be adherent than patients with other underlying etiologies (72.6%; OR:0.52, CI:0.28-0.96; P=.036). While patients with cerebral palsy (80.5%) trended towards more likely to adhere compared to other etiologies (70.6%; OR:1.72, CI:0.96-3.10; P=.070). Additionally, patients naïve to botulinum toxins for spasticity were less likely to adhere to treatment than non-naïve patients (63.6% vs. 76.4%, respectively; OR:0.54, CI:0.39-0.75; P<.001). Patient characteristics that did not impact treatment adherence included age, gender, and pattern or severity of spasticity.
Conclusions: This preliminary analysis from ASPIRE suggests that TBI patients or those naïve to botulinum toxins for spasticity are at increased risk of treatment non-adherence. Further analysis of risk factors that impact onabotulinumtoxinA treatment adherence can help optimize spasticity management strategies to improve long-term patient care.
Level of Evidence: Level I
To cite this abstract in AMA style:
Esquenazi A, Wittenberg GF, Gallien P, Baricich A, Fanning K, Zuzek A, Francisco GE, Bandari DS. Clinical Characteristics That Impact OnabotulinumtoxinA Treatment Adherence in Patients with Spasticity from ASPIRE [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/clinical-characteristics-that-impact-onabotulinumtoxina-treatment-adherence-in-patients-with-spasticity-from-aspire/. Accessed May 12, 2025.« Back to AAPM&R Annual Assembly 2019
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/clinical-characteristics-that-impact-onabotulinumtoxina-treatment-adherence-in-patients-with-spasticity-from-aspire/