Category: Spasticity
Objective: Assess longitudinal goal attainment with repeated injections of abobotulinumtoxinA (aboBoNT-A) in the lower-limb over 16-months in a routine clinical setting.
Background: While the efficacy and safety of aboBoNT-A in reducing lower limb spasticity (LLS) has been established in controlled clinical trials, there is a paucity of information on clinical goal attainment in practice.
Method: Prospective, longitudinal (16-month), observational study (NCT04050527) exploring the real-world effectiveness of aboBoNT-A for LLS. Ambulatory adult patients (≥18 years) with unilateral LLS (able to take ≥5 steps with/without assistance) were treated in accordance with local guidelines to achieve individualized treatment goals. The primary endpoint was goal attainment as assessed using the cumulated Goal Attainment Scaling-Leg (GAS-leg) T score, across all treatment cycles for each patient. Analyses were performed for the effectiveness population (n=384) who underwent ≥1 BoNT-A injection cycle and had ≥1 GAS assessment.
Results: Overall, participants underwent a median of 5 lower limb injection cycles (mean±SD injection interval 18.3±6.1 weeks). Participants generally achieved their goals as expected over repeated cycles; the mean GAS-leg T score at baseline was 38.0 [95% CI 37.7, 38.3], the mean cumulated GAS-leg T score at 16 months was 48.2 [47.4, 48.9], and the mean change from baseline was 9.9 [9.1, 10.7]). Participants injected with a guidance technique at baseline (electromyography, electrostimulation, or ultrasound) were more likely to attain their primary treatment goals during cycle 1 (odds ratio: 1.9 [95% CI 1.1, 3.1], p=0.02). Overall 56 (13.5%) participants reported ≥1 adverse event, of which six participants (1.4%) had treatment-related adverse events.
Conclusion: This international real world clinical study provides evidence for the benefit of repeated cycles of aboBoNT-A in lower limb spasticity and demonstrates the importance of multi-muscle injections.
To cite this abstract in AMA style:
A. Esquenazi, R. Zorowitz, S. Ashford, M. Beneteau, P. Maisonobe, C. Hannes, J. Jacinto. Effectiveness of abobotulinumtoxinA in adults with lower limb spasticity: Results from the AboLiSh real world observational study [abstract]. Mov Disord. 2024; 39 (suppl 1). https://www.mdsabstracts.org/abstract/effectiveness-of-abobotulinumtoxina-in-adults-with-lower-limb-spasticity-results-from-the-abolish-real-world-observational-study/. Accessed June 14, 2025.« Back to 2024 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/effectiveness-of-abobotulinumtoxina-in-adults-with-lower-limb-spasticity-results-from-the-abolish-real-world-observational-study/