Botulinum toxin A for post-stroke spasticity: Insights from the French National Hospital Discharge Database...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Pharmacology

Background:

• Botulinum neurotoxin type A (BoNT-A) is an established treatment for post-stroke spasticity.
• Real-world utilization patterns of BoNT-A for post-stroke spasticity in France are not well-documented.
• Understanding current trends is essential for improving patient management strategies.

Purpose of the Study:

• To evaluate the trends in Botulinum neurotoxin type A (BoNT-A) utilization among stroke survivors in France.
• To analyze BoNT-A treatment rates based on patient demographics and care pathways.
• To identify potential barriers and opportunities for optimizing BoNT-A therapy.

Main Methods:

• Retrospective cohort study utilizing the French National Hospital Discharge Database (2015-2023).
• Analysis of stroke hospitalizations and BoNT-A treatment rates stratified by age and care pathway.
• Estimation of spasticity prevalence, BoNT-A use, and treatment timing in a sub-cohort of stroke survivors.

Main Results:

• Overall BoNT-A treatment rates for post-stroke spasticity remained low, increasing from 1.4% to 1.9% between 2015 and 2022.
• Higher BoNT-A utilization was observed in younger adults (20-29 years) and patients managed in specialized neurovascular or neurorehabilitation units.
• The median time from stroke onset to the first BoNT-A injection was 258 days, indicating potential delays in treatment initiation.

Conclusions:

• Botulinum neurotoxin type A (BoNT-A) is significantly underutilized for managing post-stroke spasticity in France.
• Current treatment rates highlight a critical need to improve patient access to and adherence with BoNT-A therapy.
• Optimizing post-stroke spasticity management requires addressing systemic factors influencing BoNT-A accessibility and consistent application.