Author Of 1 Presentation
P1084 - Adherence to OnabotulinumtoxinA Treatment in Multiple Sclerosis Patients with Spasticity from the ASPIRE Study (ID 910)
Abstract
Background
An increased understanding of factors that impact onabotulinumtoxinA treatment adherence can help improve spasticity management strategies.
Objectives
Identify baseline clinical characteristics and treatment-related factors that impact adherence to onabotulinumtoxinA treatment in patients with multiple sclerosis (MS) from the Adult Spasticity International Registry (ASPIRE) study.
Methods
International, prospective, observational registry (NCT01930786). Patients were treated with onabotulinumtoxinA for spasticity at the clinician’s discretion. Clinically meaningful thresholds for treatment adherence (≥3 treatment sessions in 2-year study)/non-adherence (≤2 sessions) were used. Data were analyzed using descriptive statistics, with unadjusted p-values shown. Statistical significance, P<0.05; non-significant effects of clinical interest, P<0.10. Data for treatment-related factors from sessions 1 and 2 only.
Results
Of the MS population (N=119), 92 patients (77.3%) were categorized as treatment adherent, with 5.4 (±1.6 [mean±SD]) treatment sessions, and 27 patients (22.7%) as non-adherent, with 1.5 (±0.5). Baseline characteristics that impacted adherence: MS type (relapsing/remitting [87.2%] and other [82.1%] more adherent than secondary progressive [63.8%], p=0.028), naïve to botulinum toxin(s) for spasticity (naïve [67.6%] less adherent than non-naïve [81.7%], p=0.088), severity of spasticity (adherent patients treated for the lower limb [p=0.067] or both limbs [p=0.074] had higher severity scores than non-adherent), and treatment modalities (acupuncture used [100.0%] more adherent than not mentioned [74.8%], p=0.048; assistive device[s] used [74.0%] less adherent than not mentioned [91.3%], p=0.074). Treatment-related factors that impacted adherence: treatment interval (<15 weeks [94.3%] more adherent than ≥15 weeks [80.8%], p=0.035), lower limb clinical presentations (treated for equinovarus foot [84.7%] more adherent than not [66.0%], p=0.017; treated for flexed hip [100.0%] more adherent than not [75.2%], p=0.073; treated for flexed toes [93.8%] more adherent than not [74.8%], p=0.091; treated for stiff extended knee [67.5%] less adherent than not [82.3%], p=0.069), and clinician satisfaction (satisfied that onabotulinumtoxinA helped manage spasticity [88.5%] more adherent than dissatisfied [0.0%], p=0.008; satisfied that onabotulinumtoxinA helped with therapy/exercise [88.5%] more adherent than dissatisfied [0.0%], p=0.008).
Conclusions
These descriptive analyses from ASPIRE provide real-world insights into factors that can impact adherence to onabotulinumtoxinA treatment for spasticity, which can be used to help optimize management strategies to improve MS patient care.