Ontology highlight
ABSTRACT: Introduction
OnabotulinumtoxinA treatment for spasticity is dependent on numerous factors and varies according to selected treatment goals.Objective
To examine real-world onabotulinumtoxinA treatment utilization and effectiveness in patients with upper limb spasticity over 2 years from the Adult Spasticity International Registry (ASPIRE) study.Design
Multicenter, prospective, observational registry (NCT01930786).Setting
Fifty-four international clinical sites in North America, Europe, and Asia.Patients
Adults (naïve or non-naïve to botulinum toxins for spasticity) with upper limb focal spasticity related to upper motor neuron syndrome across multiple etiologies.Interventions
OnabotulinumtoxinA administered at clinician's discretion.Main outcome measures
OnabotulinumtoxinA utilization, clinician and patient satisfaction.Results
Four hundred eighty-four patients received ≥1 treatment of onabotulinumtoxinA for upper limb spasticity. Patients were on average 55.1 years old, 50.8% male, predominantly Caucasian (72.3%), and 38.6% were naïve to botulinum toxins. Stroke was the most frequently reported underlying etiology (74.0%). Most patients (81.2%) had moderate to severe spasticity at baseline. The most commonly treated upper limb clinical presentation was clenched fist (79.1% of patients). Across all presentations, onabotulinumtoxinA doses ranged between 5-600U. Electromyography (EMG) was most often utilized to localize muscles (≥57.0% of treatment sessions). Clinicians (92.9% of treatment sessions) and patients (85.7%) reported being extremely satisfied/satisfied that treatment helped manage spasticity, and clinicians (98.6%) and patients (92.2%) would definitely/probably continue onabotulinumtoxinA treatment. One hundred seventy-nine patients (37.0%) reported 563 adverse events (AEs); 15 AEs in 14 patients (2.9%) were considered treatment related. Sixty-nine patients (14.3%) reported 137 serious AEs; 3 serious AEs in 2 patients (0.4%) were considered treatment related. No new safety signals were identified.Conclusions
ASPIRE captured the real-world individualized nature of onabotulinumtoxinA utilization for upper limb spasticity over 2 years, with consistently high clinician- and patient-reported satisfaction. Data in this primary analysis will guide clinical use of onabotulinumtoxinA, as well as provide insights to improve educational programs on spasticity management.
SUBMITTER: Francisco GE
PROVIDER: S-EPMC7687094 | biostudies-literature | 2020 Nov
REPOSITORIES: biostudies-literature
PM & R : the journal of injury, function, and rehabilitation 20200227 11
<h4>Introduction</h4>OnabotulinumtoxinA treatment for spasticity is dependent on numerous factors and varies according to selected treatment goals.<h4>Objective</h4>To examine real-world onabotulinumtoxinA treatment utilization and effectiveness in patients with upper limb spasticity over 2 years from the Adult Spasticity International Registry (ASPIRE) study.<h4>Design</h4>Multicenter, prospective, observational registry (NCT01930786).<h4>Setting</h4>Fifty-four international clinical sites in N ...[more]