Journal CME November 2024, Pain, disability, and quality of life in participants after concurrent onabotulinumtoxinA treatment of upper and lower limb spasticity: Observational results from the ASPIRE study-PM R - 2024 - Bavikatte - Pain disability and quality of life in participants after concurrent onabotulinumtoxinA

PM R - 2024 - Bavikatte - Pain disability and quality of life in participants after concurrent onabotulinumtoxinA

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The ASPIRE study evaluated the effects of concurrent onabotulinumtoxinA (onabotA) treatment for upper and lower limb spasticity, conditions linked to neurological disorders such as stroke, multiple sclerosis, and cerebral palsy. Conducted over two years, the multicenter, international, prospective, observational registry involved 744 adults, with 730 receiving at least one treatment session. Among them, 275 participants had simultaneous onabotA injections in both limbs across various etiologies.<br /><br />Results indicated high satisfaction among both physicians and participants, reporting improvements in pain, disability, and quality of life (QoL). On average, doses per session ranged from 421 to 500 units, administered at clinicians' discretion, and included guided and anatomic treatments. Pain was assessed using the Numeric Pain Rating Scale, and significant reductions were recorded following most treatments. Disability was measured using the Disability Assessment Scale, revealing improvements post-treatment. The Spasticity Impact Assessment evaluated the effect of spasticity on daily life, showing reduced difficulty in daily activities post-treatment.<br /><br />Adverse events were minimal, with nine treatment-related adverse events and three serious ones, such as dysphagia and muscular weakness. Despite the real-world setting, the study's non-randomized, non-blind nature and the predominance of stroke patients may limit generalizability. Overall, the study supports concurrent onabotA use for reducing spasticity-related impairments, consistent with established safety, enhancing patient care and management of spasticity in clinical practice.<br /><br />AbbVie funded the study, aligning with ethical standards and received approval by respective institutional review boards. The study highlights the potential broad application of onabotA in clinical settings, aiding healthcare providers in the treatment and management of spasticity, potentially offering improved outcomes in diverse patient populations.

Keywords

onabotulinumtoxinA

spasticity

neurological disorders

stroke

multiple sclerosis

cerebral palsy

pain reduction

quality of life

adverse events

clinical practice