Switching adult patients with spasticity from onabotulinumtoxinA to abobotulinumtoxinA: a real-world data analysis across three US-based treatment centers.

Aim: To assess patient characteristics, treatment patterns, botulinum toxin type-A (BoNT-A) costs and describe safety in adults with spasticity who switched from onabotulinumtoxinA to abobotulinumtoxinA. Materials & methods: Chart data from three US-based treatment centers was collected in patients aged ≥18 years with upper limb (ULS), lower limb (LLS) or ULS and LLS (ULS + LLS) spasticity. Eligible patients had ≥2 onabotulinumtoxinA treatment cycles before switching to abobotulinumtoxinA; they were followed for three additional abobotulinumtoxinA treatment cycles. A post hoc analysis of estimated drug costs was conducted.

Results

Eighty-eight patients (mean age 44.9 years; 62.5% male) switched from onabotulinumtoxinA to abobotulinumtoxinA; in 84 (95.5%), the switch was due to 'medical need/effectiveness not achieved.' Most common spasticity etiologies were cerebral palsy (43.2%) and stroke (25.0%). Fifty-one patients (58.0%) had bilateral spasticity with a mean ± SD of 5.1 ± 2.2 muscles injected at each visit over the 5-injection-cycle treatment period. No adverse events were reported following switching. Mean estimated cost per visit was $2731 with onabotulinumtoxinA and $1452 with abobotulinumtoxinA.

Conclusion

In this real-world study, patients with ULS, LLS or ULS + LLS who were switched from onabotulinumtoxinA to abobotulinumtoxinA continued for ≥3 treatment cycles without any reported adverse events. Switching resulted in lower estimated BoNT-A costs.