Long-term adherence and response to botulinum toxin in different indications

Area of Science:

• Neurology
• Pharmacology
• Medical Treatment

Background:

• Long-term efficacy and patient adherence are crucial for botulinum neurotoxin type A (BoNT-A) treatments.
• Understanding factors influencing adherence and response is vital for optimizing patient care in various neurological conditions.

Purpose of the Study:

• To analyze adherence and self-perceived treatment response to long-term BoNT-A therapy across different neurological indications.
• To identify patient groups with varying long-term outcomes in BoNT-A treatment.

Main Methods:

• Retrospective analysis of 1351 patients and 20705 injection appointments from a BoNT outpatient clinic (1989-2014).
• Longitudinal analysis of therapy duration and BoNT-A dosage.
• Cross-sectional evaluation of self-perceived health, symptom reduction, and clinical global impression.
• Analysis of mouse hemidiaphragm assay antibodies (MHDA-ABs) in a subgroup.

Main Results:

• Mean treatment duration was 4.58 years; 50.2% of patients discontinued therapy within 8 years.
• Therapy adherence and self-perceived symptom reduction were significantly better in blepharospasm (BSP), hemifacial spasm (HFS), and cervical dystonia (CD) compared to other dystonia (ODT) and spasticity (SPAS).

Conclusions:

• Treatment indication significantly influences long-term adherence and self-perceived symptom reduction in BoNT-A therapy.
• BSP, HFS, and CD patients demonstrate superior long-term outcomes compared to ODT and SPAS patients.
• MHDA-ABs impacted symptom reduction, but to a limited extent.