Objective: To identify patient demographics and clinical characteristics that impact onabotulinumtoxinA treatment adherence from the Adult Spasticity International Registry (ASPIRE) study.

Background: A better understanding of factors that impact onabotulinumtoxinA treatment adherence can help better define clinical strategies to manage spasticity.

Method: Multicenter, international, prospective, observational registry (NCT01930786). Adult patients with spasticity across multiple etiologies were treated with onabotulinumtoxinA at their clinician’s discretion over 2 years. 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=0.036). 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=0.070). 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<0.001). Patient characteristics that did not impact treatment adherence included age, gender, and pattern or severity of spasticity.

Conclusion: 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.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-characteristics-that-impact-onabotulinumtoxina-treatment-adherence-in-patients-with-spasticity-from-aspire/