Reasons and Determinants of BoNT-A Treatment Discontinuation in Patients Living with Spasticity: A 10-Year Retrospective Analysis

This study looked at why patients with spasticity, a condition causing muscle stiffness and spasms due to brain or spinal cord injuries, stopped their botulinum toxin type A (BoNT-A) treatments. The research found that the main reasons for stopping treatment were logistical issues like difficulty getting to appointments, or the need for surgeries or intrathecal baclofen (ITB) therapy. The study suggests that patients with severe spasticity, no pain, limited access to rehabilitation, and cognitive issues were more likely to discontinue BoNT-A treatment, highlighting the importance of comprehensive care and support.

• 1
  Logistic reasons (including distance problems and difficulty in being accompanied) were the most common reason reported for treatment discontinuation (21, [37.5%]), especially in stroke patients
• 2
  Orthopedic surgeries and intrathecal baclofen therapy (ITB) were frequently a reason for discontinuation for spinal cord injury (7, [70%]) and traumatic brain injury (5, [71.43%]).
• 3
  Patients severe spasticity (95% CI = 1.047-1.639), no pain (95% CI = 1.396-2.302), with no rehabilitation regimen (95% CI = 1.120-1.760), with cognitive impairment (95% CI = 1.110-1.670) are significantly more likely to discontinue follow-up early.