Real-world differences in dosing and clinical utilization of OnabotulinumtoxinA and AbobotulinumtoxinA in the treatment of upper limb spasticity

Bohart, Zachary; Dashtipour, Khashayar; Kim, Heakyung; Schwartz, Marc; Zuzek, Aleks; Singh, Ritu; Nelson, Mariana

doi:10.1016/j.toxicon.2024.107678

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…For instance, the doses, numbers, and locations of recommended muscles and injection sites in upper limb spasticity are different for onabotA [ 4 ] and abobotA [ 7 ], making it difficult to design studies with protocols optimized for each. These differences are confirmed by a recent analysis of real-world studies in upper limb spasticity that found that the two products were not only injected at different doses, but also at different ratios of doses per muscle, indicating that the products are not used at a set dose ratio in clinical practice [ 189 ]. This study of adult post-stroke patients also found that a higher number of muscles were injected with onabotA than abobotA [ 189 ].…”

Section: Bont Efficacy and Duration Of Actionmentioning

confidence: 69%

“…These differences are confirmed by a recent analysis of real-world studies in upper limb spasticity that found that the two products were not only injected at different doses, but also at different ratios of doses per muscle, indicating that the products are not used at a set dose ratio in clinical practice [ 189 ]. This study of adult post-stroke patients also found that a higher number of muscles were injected with onabotA than abobotA [ 189 ]. These differences are underscored by the different injection paradigms outlined in the product labels, which for onabotA includes 13 potential muscles to be injected in upper limb spasticity [ 4 ] and for abobotA includes 9 potential muscles [ 7 ].…”

Section: Bont Efficacy and Duration Of Actionmentioning

confidence: 69%

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Update on Non-Interchangeability of Botulinum Neurotoxin Products

Brin,

Nelson,

Ashourian

et al. 2024

Toxins

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The growing use of botulinum neurotoxins (BoNTs) for medical and aesthetic purposes has led to the development and marketing of an increasing number of BoNT products. Given that BoNTs are biological medications, their characteristics are heavily influenced by their manufacturing methods, leading to unique products with distinct clinical characteristics. The manufacturing and formulation processes for each BoNT are proprietary, including the potency determination of reference standards and other features of the assays used to measure unit potency. As a result of these differences, units of BoNT products are not interchangeable or convertible using dose ratios. The intrinsic, product-level differences among BoNTs are compounded by differences in the injected tissues, which are innervated by different nerve fiber types (e.g., motor, sensory, and/or autonomic nerves) and require unique dosing and injection sites that are particularly evident when treating complex therapeutic and aesthetic conditions. It is also difficult to compare across studies due to inherent differences in patient populations and trial methods, necessitating attention to study details underlying each outcome reported. Ultimately, each BoNT possesses a unique clinical profile for which unit doses and injection paradigms must be determined individually for each indication. This practice will help minimize unexpected adverse events and maximize efficacy, duration, and patient satisfaction. With this approach, BoNT is poised to continue as a unique tool for achieving individual goals for an increasing number of medical and aesthetic indications.

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Section: Bont Efficacy and Duration Of Actionmentioning

confidence: 69%

Section: Bont Efficacy and Duration Of Actionmentioning

confidence: 69%

Update on Non-Interchangeability of Botulinum Neurotoxin Products

Brin,

Nelson,

Ashourian

et al. 2024

Toxins

Self Cite

View full text Add to dashboard Cite

show abstract

Botulinum Toxin Type A (BoNT-A) Use for Post-Stroke Spasticity: A Multicenter Study Using Natural Language Processing and Machine Learning

Antón,

Molina,

Pérez

et al. 2024

Toxins

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We conducted a multicenter and retrospective study to describe the use of botulinum toxin type A (BoNT-A) to treat post-stroke spasticity (PSS). Data were extracted from free-text in electronic health records (EHRs) in five Spanish hospitals. We included adults diagnosed with PSS between January 2015 and December 2019, stratified into BoNT-A-treated and untreated groups. We used EHRead® technology, which incorporates natural language processing and machine learning, as well as SNOMED CT terminology. We analyzed demographic data, stroke characteristics, BoNT-A use patterns, and other treatments. We reviewed the EHRs of 1,233,929 patients and identified 2190 people with PSS with a median age of 69 years; in total, 52.1% were men, 70.7% had cardiovascular risk factors, and 63.2% had suffered an ischemic stroke. Among the PSS patients, 25.5% received BoNT-A at least once. The median time from stroke to spasticity onset was 205 days, and the time from stroke to the first BoNT-A injection was 364 days. The primary goal of BoNT-A treatment was pain control. Among the study cohort, rehabilitation was the most common non-pharmacological treatment (95.5%). Only 3.3% had recorded monitoring scales. In conclusion, a quarter of patients with PSS received BoNT-A mainly for pain relief, typically one year after the stroke. Early treatment, disease monitoring, and better data documentation in EHRs are crucial to improve PSS patients’ care.

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Real-world differences in dosing and clinical utilization of OnabotulinumtoxinA and AbobotulinumtoxinA in the treatment of upper limb spasticity

Cited by 2 publications

References 19 publications

Update on Non-Interchangeability of Botulinum Neurotoxin Products

Update on Non-Interchangeability of Botulinum Neurotoxin Products

Botulinum Toxin Type A (BoNT-A) Use for Post-Stroke Spasticity: A Multicenter Study Using Natural Language Processing and Machine Learning

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