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OnabotulinumtoxinA Dosing Is Consistent over Time Regardless of Treatment Interval: Analysis from the Adult Spasticity International Registry (ASPIRE)

Alberto Esquenazi, MD (MossRehab , Elkins Park, Pennsylvania); Aleksej Zuzek, PhD; Gerard E. Francisco, MD; Philippe Gallien, MD; Alessio Baricich, MD; Kristina M. Fanning; Daniel S. Bandari, MD; Wayne Feng, MD; George F. Wittenberg, MD, PhD

Meeting: AAPM&R Annual Assembly 2021

Categories: Neurological Rehabilitation (2021)

Session Information

Session Title: AA 2021 Virtual Posters - Neurological Rehabilitation

Session Time: None. Available on demand.

Disclosures: Alberto Esquenazi, MD: Allergan (Products/Services: Yes) (Consultant/Advisory Board, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)Ipsen (Products/Services: Yes, No) (Consultant/Advisory Board, Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)Merz (Products/Services: Yes) (Research Grant includes principal investigator, collaborator or consultant and pending grants as well as grants already received)

Objective: To evaluate the relationship between dosing and treatment intervals of onabotulinumtoxinA for real-world treatment of adult spasticity.

Design: The Adult Spasticity International Registry (ASPIRE; ClinicalTrials.gov, NCT01930786) is a prospective, observational, international registry of onabotulinumtoxinA treatment for adult spasticity.Setting : International clinical sites.Participants : Patients with spasticity (N&#3f730) who were treatment-adherent (received ≥3 treatment sessions with onabotulinumtoxinA over 2 years).

Interventions: Treating physicians determined dosing and treatment intervals of onabotulinumtoxinA.

Main Outcome Measures: Patients were separated into treatment interval groups (N&#3f2373 intervals): < 12, 12-14, 15-17, 18-20, and ≥21 weeks. Assessments were patient/clinician satisfaction items and adverse events (AEs).

Results: OnabotulinumtoxinA doses were generally consistent among the treatment interval groups, ranging from a mean dose of 335U (for ≥21 weeks) to 387U (for 12-14 weeks). Most patients (63-76%) across all treatment interval groups received doses within the approved range (≤400U). Dosing slightly increased over treatment sessions, from 355U at session 2 to 453U at session 8. High rates of satisfaction were reported over treatment sessions: 81-92% treatment-adherent patients stated that onabotulinumtoxinA treatment helped in managing their spasticity, 73-82% were satisfied/extremely satisfied with the duration of effect, and 91-96% planned to continue use of onabotulinumtoxinA; clinicians reported similar rates, with 93-99%, 84-94%, and 99-100% answering in the affirmative, respectively. Fall (5.5%), urinary tract infection (2.6%), and muscular weakness (2.6%) were the most commonly reported AEs.Conclusions: Consistent dosing of onabotulinumtoxinA for adult spasticity was seen irrespective of treatment interval. Most patients received approved dosing levels of onabotulinumtoxinA. High patient/clinician satisfaction was reported, with no new safety signals.

Level of Evidence: Level II

To cite this abstract in AMA style:

Esquenazi A, Zuzek A, Francisco GE, Gallien P, Baricich A, Fanning KM, Bandari DS, Feng W, Wittenberg GF. OnabotulinumtoxinA Dosing Is Consistent over Time Regardless of Treatment Interval: Analysis from the Adult Spasticity International Registry (ASPIRE) [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/onabotulinumtoxina-dosing-is-consistent-over-time-regardless-of-treatment-interval-analysis-from-the-adult-spasticity-international-registry-aspire/. Accessed May 11, 2025.
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