Table 2.
Utilization of OnabotulinumtoxinA in Patients Treated for Lower Limb Spasticity (N = 530) in the ASPIRE Study *
| Equinovarus Foot | Flexed Knee | Stiff Ext. Knee | Flexed Toes | Adducted Thigh | Hitchhiker Toe | Flexed Hip | |
|---|---|---|---|---|---|---|---|
| Patients, N (%) | 429 (80.9) | 138 (26.0) | 119 (22.5) | 118 (22.3) | 107 (20.2) | 65 (12.3) | 44 (8.3) |
| Treatment Sessions, n | 1609 | 450 | 364 | 292 | 373 | 179 | 116 |
| Dose (U) | |||||||
| Mean (SD) | 220 (131) | 154 (103) | 138 (123) | 68 (54) | 162 (101) | 43 (23) | 93 (66) |
| Mode | 200 | 100 | 100 | 50 | 100 | 50 | 100 |
| Min, Max | 15, 900 | 12, 1000 | 24, 1100 | 10, 400 | 20, 550 | 10, 100 | 15, 400 |
| Dilution (U/mL), † n (%) | |||||||
| <25 | 55 ( 3.4) | 16 ( 3.6) | 10 ( 2.7) | 2 ( 0.7) | 9 ( 2.4) | 5 ( 2.8) | 4 ( 3.4) |
| 25 | 236 (14.7) | 50 (11.1) | 28 ( 7.7) | 17 ( 5.8) | 55 (14.7) | 29 (16.2) | 17 (14.7) |
| 50 | 667 (41.5) | 159 (35.3) | 182 (50.0) | 142 (48.6) | 137 (36.7) | 72 (40.2) | 54 (46.6) |
| 100 | 577 (35.9) | 182 (40.4) | 114 (31.3) | 117 (40.1) | 135 (36.2) | 69 (38.5) | 23 (19.8) |
| Other | 109 ( 6.8) | 47 (10.4) | 32 ( 8.8) | 14 ( 4.8) | 40 (10.7) | 4 ( 2.2) | 18 (15.5) |
| Needle Length (mm), † n (%) | |||||||
| 10 | 111 ( 6.9) | 31 ( 6.9) | 7 ( 1.9) | 29 ( 9.9) | 21 ( 5.6) | 20 (11.2) | 0 ( 0.0) |
| 37 | 743 (46.2) | 162 (36.0) | 121 (33.2) | 120 (41.1) | 113 (30.3) | 83 (46.4) | 49 (42.2) |
| 50 | 407 (25.3) | 95 (21.1) | 113 (31.0) | 82 (28.1) | 75 (20.1) | 46 (25.7) | 23 (19.8) |
| 75 | 34 ( 2.1) | 2 ( 0.4) | 9 ( 2.5) | 5 ( 1.7) | 1 ( 0.3) | 1 ( 0.6) | 2 ( 1.7) |
| Other | 438 (27.2) | 164 (36.4) | 114 (31.3) | 57 (19.5) | 164 (44.0) | 29 (16.2) | 44 (37.9) |
| Injections, † n (%) | |||||||
| 1 | 86 ( 5.3) | 37 ( 8.2) | 61 (16.8) | 130 (44.5) | 31 ( 8.3) | 129 (72.1) | 42 (36.2) |
| 2 | 172 (10.7) | 93 (20.7) | 104 (28.6) | 87 (29.8) | 63 (16.9) | 44 (24.6) | 29 (25.0) |
| 3 | 208 (12.9) | 36 ( 8.0) | 54 (14.8) | 28 ( 9.6) | 37 ( 9.9) | 4 ( 2.2) | 8 ( 6.9) |
| 4 | 263 (16.3) | 108 (24.0) | 47 (12.9) | 20 ( 6.8) | 109 (29.2) | 2 ( 1.1) | 24 (20.7) |
| 5 | 176 (10.9) | 34 ( 7.6) | 8 ( 2.2) | 8 ( 2.7) | 19 ( 5.1) | 0 ( 0.0) | 0 ( 0.0) |
| ≥6 | 704 (43.8) | 142 (31.6) | 90 (24.7) | 19 ( 6.5) | 114 (30.5) | 0 ( 0.0) | 13 (15.5) |
| Treatment Side, † n (%) | |||||||
| Right | 633 (39.3) | 125 (27.8) | 131 (36.0) | 114 (39.0) | 60 (16.1) | 80 (44.7) | 36 (31.0) |
| Left | 708 (44.0) | 131 (29.1) | 121 (33.2) | 161 (55.1) | 70 (20.6) | 91 (50.8) | 33 (28.4) |
| Both | 268 (16.7) | 194 (43.1) | 112 (30.8) | 17 ( 5.8) | 236 (63.3) | 8 ( 4.5) | 47 (40.5) |
| Localization Method, ‡ n (%) | |||||||
| Anatomical | 556 (34.6) | 212 (47.1) | 126 (34.6) | 120 (41.1) | 213 (57.1) | 45 (25.1) | 51 (44.0) |
| E‐stim | 435 (27.0) | 26 ( 5.8) | 79 (21.7) | 118 (40.4) | 36 ( 9.7) | 63 (35.2) | 6 ( 5.2) |
| EMG | 807 (50.2) | 254 (56.4) | 175 (48.1) | 147 (50.3) | 153 (41.1) | 74 (41.3) | 68 (58.6) |
| Ultrasound | 398 (24.7) | 54 (12.0) | 74 (20.3) | 55 (18.8) | 42 (11.3) | 57 (31.8) | 15 (12.9) |
EMG = electromyography; E‐stim = electrical stimulation; Max = maximum; Min = minimum; N = number of patients; n = number of treatment sessions; SD = standard deviation; U = units of onabotulinumtoxinA.
Data are stratified by lower limb clinical presentations. Presentations and muscles targeted are not mutually exclusive, and therefore, may exceed 100%.
For each clinical presentation, data are the aggregate of all treatment sessions during the 2‐year study. Categories for dilution and needle length are not mutually exclusive.
Injection localization methods were not mutually exclusive. Localization method data may not necessarily reflect clinician preference, but instead be an indication of equipment available at the study site. “Anatomical” localization refers to palpation. For each clinical presentation, data are the aggregate of all treatment sessions during the 2‐year study.