Switching Adults With Spasticity From OnabotulinumtoxinA to AbobotulinumtoxinA: Real-World Data Across Three US-Based Centers

Abstract

<h3>Research Objectives</h3> To illustrate the safe transitioning from onabotulinumtoxinA (onaBoNT-A) to abobotulinumtoxinA (aboBoNT-A) in adults with spasticity. <h3>Design</h3> Retrospective study of patient chart data. <h3>Setting</h3> Three US-based treatment centers. <h3>Participants</h3> Patients aged ≥18 years with upper limb (ULS), lower limb (LLS), or ULS and LLS (ULS+LLS) spasticity. <h3>Interventions</h3> ≥2 onaBoNT-A treatment cycles, followed by ≥3 aboBoNT-A treatment cycles. <h3>Main Outcome Measures</h3> The transition of patients from onaBoNT-A to aboBoNT-A. <h3>Results</h3> A total of 88 patients (mean±SD age 44.9±19.6; 62.5% male) switched from onaBoNT-A to aboBoNT-A; in 84 (95.5%), the switch was due to "medical need/effectiveness not achieved." Spasticity etiologies included stroke (25.0%), traumatic brain injury (13.6%), spinal cord injury (2.3%), cerebral palsy (42.0%), multiple sclerosis (9.1%), and other (8.0%). Fifty-one patients (58.0%) had bilateral spasticity, with 5.0±2.2 muscles injected at each visit over the 5-injection-cycle treatment period. Across the 2 initial cycles prior to the switch, mean doses of onaBoNT-A were 425.0±179.0U, 477.1±132.8U, and 454.2±156.0U for ULS, LLS, and ULS+LLS, respectively; following the switch, mean aboBoNT-A doses across 3 treatment cycles were 1005.1±439.2U, 1006.2±334.2U, and 1203.2±325.7U, respectively. No adverse events (AEs) were reported following conversion. <h3>Conclusions</h3> Patients who switched from onaBoNT-A to aboBoNT-A continued for at least 3 treatment cycles without any reported AEs. Mean doses of both onaBoNT-A and aboBoNT-A were generally aligned with the upper ranges of their respective dosing guidelines. Further randomized crossover studies evaluating the efficacy and safety of onaBoNT-A versus aboBoNT-A are warranted. <h3>Author(s) Disclosures</h3> NW: Employee of Cerner Enviza (Kantar Health); ED: Received consultancy fees and/or research support from Allergan, Ipsen, Solstice, Merz; MP and MT: None; JM, AM, and JB: Employees of Ipsen.