Abstract number: ESOC2026A1166 persistence with botulinum toxin a and factors associated with discontinuation in patients with stroke: a retrospective cohort study
Abstract
Abstract Background and aims BotulinumtoxinA (BoNT-A) is a guideline-recommended treatment for spasticity following stroke. We evaluated BoNT-A treatment persistence drivers of discontinuation and predictors of non-persistence in patients with stroke. Methods Eligible adults had received ≥1 treatment cycle with BoNT-A at the Mayo Clinic (January 2010–June 2023) and had an International Classification of Diseases (ICD9/10) code for stroke. Patients with ICD9/10 codes for migraine, cerebral palsy, cervical dystonia, or bladder dysfunction were excluded. Index date (baseline) was the date of first BoNT-A treatment; follow-up was 2 years post-index. Patients were persistent if all treatment intervals post-index were ≤the 80th percentile of all patients. Reasons for discontinuation were identified by AI natural language processing analysis of physicians’ free-text notes. Baseline characteristics associated with non-persistence were identified using step-wise logistic regression analyses. Results Overall, 407 patients were included. The 80th percentile of the BoNT-A treatment interval was 154 days; 5.7% of patients were persistent. Mean (95%CI) number of BoNT-A treatments over the 2-year follow-up was 2.43 (2.24–2.63) cycles. Comorbidity burden was high (Table 1). The most common reasons for BoNT-A discontinuation were patient- and physician-reported lack of treatment effectiveness (Table 2). Older age, Hispanic/Latino/unknown/undisclosed ethnicity, presence of comorbidities, and…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 407 participants or records.
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