Session Information
Session Title: AA 2022 Posters - Neurological Rehabilitation
Session Time: None. Available on demand.
Disclosures: Alberto Esquenazi, MD: IPSEN (Products/Services: Yes) (Consultant/Advisory Board, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)
Background and/or Objectives: To examine utilization patterns of onabotulinumtoxinA (onabotA) treatment within 8 additional muscle groups consistent with updated US label in patients with upper limb (UL) spasticity from the Adult Spasticity International Registry (ASPIRE) study over a 2-year period.
Design: Multicenter, prospective, observational study (NCT01930786)
Setting: US clinical sites
Participants: Adult patients who received onabotA to UL muscles to treat spasticity
Interventions: Total onabotA dose of ≤400U injected per treatment session consistent with US label
Main Outcome Measures: OnabotA treatment utilization
Results: Of 443 US patients, 336 had UL spasticity, 45 of whom were injected with ≤400U of onabotA in selected muscles that are now consistent with the newly approved label. Mean age (SD) was 51.3 (16.0) years, 26 (58%) were male, and 23 (51%) were onabotA-naive. Postures treated included clenched fist (71.1%), flexed wrist (55.6%), flexed elbow (73.3%), thumb in palm (20.0%), intrinsic plus hand (20.0%), and pronated forearm (31.1%). Most patients (80.0%) had >1 abnormal posture. Patients who received onabotA injections only in muscles consistent with label before July 2021 included those with clenched fist (93.8%), flexed wrist (100%), flexed elbow (12.1%), and thumb in palm (33.3%). Patients who received onabotA injections in muscles consistent with the expanded label in July 2021 included all those with clenched fist, flexed wrist, flexed elbow, thumb in palm, intrinsic plus hand, and pronated forearm. Of the 38 adverse events (AEs) recorded, 1 treatment-related AE (muscular weakness) and no treatment-related serious AEs were reported.
Conclusions: This ASPIRE post hoc analysis provides real-world evidence of the opportunity to educate on the expanded label for onabotA with attention to elbow, forearm, and finger postures and the ability to treat, on-label, multiple UL postures more holistically. This research is similar to that previously submitted to International Society of Physical and Rehabilitation Medicine (ISPRM) 2022.
Level of Evidence: Level I
To cite this abstract in AMA style:
Esquenazi A, Francisco GE, Feng W, Munin MC, Ngo K, Schwartz M, Sadeghi M, Zuzek A. Individualized OnabotulinumtoxinA Treatment of Upper Limb Spasticity in US Clinical Practices: Analysis of Practice Patterns from the ASPIRE Study [abstract]. PM R. 2022; 14(S1)(suppl 1). https://pmrjabstracts.org/abstract/individualized-onabotulinumtoxina-treatment-of-upper-limb-spasticity-in-us-clinical-practices-analysis-of-practice-patterns-from-the-aspire-study/. Accessed May 29, 2025.« Back to AAPM&R Annual Assembly 2022
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/individualized-onabotulinumtoxina-treatment-of-upper-limb-spasticity-in-us-clinical-practices-analysis-of-practice-patterns-from-the-aspire-study/