Welcome, I'm Alberto Scanasi, and I work at Moss Rehab in Philadelphia, and on behalf of my co-authors, we want to thank you and those that have participated in this study, the adherence to onabotulinum toxin A treatment in post-stroke and multiple sclerosis patients with spasticity from the ASPIRE study. The objective of this analysis was to identify baseline clinical characteristics and treatment-related variables that impact adherence to onabotulinum toxin A treatment in both post-stroke and multiple sclerosis populations from the Adult Spasticity International Registry, the ASPIRE study. ASPIRE is a two-year international multi-center prospective observational registry, which gathered data from 730 adults with spasticity across multiple etiologies who were treated at the clinician's discretion with onabotulinum toxin A. Clinical meaningful thresholds for treatment adherence and non-adherence were used for this analysis. Adherence was defined as patients who had three or more treatment sessions with onabotulinum toxin during two-year study, and non-adherence, those that had two or fewer treatment sessions. We used a multivariate logistic regression approach to analyze the stroke population and a descriptive analysis for the multiple sclerosis population. For the stroke results in ASPIRE, 411 patients had spasticity resulting from stroke and received at least one treatment with Botox. In the final model, we selected 346 patients for the analysis. That's 83.2% of the population, which was considered to be treatment-adherent with an average of 5.3 treatment sessions and a mean treatment interval between sessions one and two of approximately 18 weeks. In the final model, variables that were associated with adherence to onabotulinum toxin treatment included those patients that were treated in the European Union, the use of orthotic devices, and the treatment of thumb and palm. Additional data is clearly displayed in the poster and I encourage you to look at it carefully. For the multiple sclerosis population, we had 119 patients who received at least one treatment during the two-year study. 77% of them were classified as treatment-adherent with an average of 5.4 treatment sessions and a mean treatment interval between sessions one and two of 18 weeks. Baseline characteristics and treatment-related variables that were found to impact adherence to onabotulinum toxin A treatment included patients with secondary progressive multiple sclerosis were less adherent, patients naive to botulinum toxin for spasticity were less adherent than non-naive patients, adherent patients' treatment for the lower limb or both limbs had higher severity scores than non-adherent patients. Patients with a treatment interval greater than 15 weeks were less adherent and patients treated for equinovirus foot, flex hip, or flex toes were more adherent. Clinician satisfaction with onabotulinum toxin A to help manage spasticity or help with therapy was higher for those patients that were adherent. In conclusion, most stroke and multiple sclerosis patients adhere to onabotulinum toxin A treatment for spasticity with greater than five sessions during this two-year study. This ASPIRE analysis provides real-world insight into variables that can impact adherence to onabotulinum toxin A treatment for spasticity. And this data clearly supports a need for individualized onabotulinum toxin A treatment to optimize spasticity management strategies to improve patient care. Thank you very much. And now, we can answer questions.

ASPIRE study

adherence

onabotulinum toxin A treatment

spasticity management

multiple sclerosis