The purpose of the present study was to investigate the long-term persistence to treatment with botulinum toxin type A (BoNT-A) for multiple sclerosis (MS)-related spasticity and the determinants of BoNT-A discontinuation in daily clinical setting. We retrospectively collected data of patients who started BoNT-A injections and underwent regular follow-up visits. Determinants of BoNT-A discontinuation were explored in a time-to-event Cox regression analysis which included as independent variables a large set of demographic and clinical characteristics. A total of 185 patients started BoNT-A injections from 2002 to 2014 and were followed up to September 2016. Of them, data on 121 were considered in our analysis. At follow-up, 53 (44%) patients were still on treatment and 68 (56%) patients discontinued BoNT-A after a median time of 1.2 years [interval 6 months to 7.4 years]. The reasons for discontinuation were loss of efficacy (n = 45), logistic problems or barriers to reach the structure (n = 16), and adverse events (n = 7). The absence of caregiver (hazard ratio = 1.69, p = 0.03) and lack of regular rehabilitation (hazard ratio = 1.78, p = 0.02) were two independent predictors for BoNT-A discontinuation. Our study confirms the beneficial effect of combining BoNT-A injections with rehabilitation and highlights the crucial role of caregivers for achieving better long-term outcomes in people with MS suffering from spasticity.

Determinants of botulinum toxin discontinuation in multiple sclerosis. a retrospective study / Latino, Pamela; Castelli, Letizia; Prosperini, Luca; Marchetti, Maria Rita; Pozzilli, Carlo; Giovannelli, Morena. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - 38:10(2017), pp. 1841-1848. [10.1007/s10072-017-3078-3]

Determinants of botulinum toxin discontinuation in multiple sclerosis. a retrospective study

Latino, Pamela;Castelli, Letizia;Prosperini, Luca;MARCHETTI, MARIA RITA;Pozzilli, Carlo;
2017

Abstract

The purpose of the present study was to investigate the long-term persistence to treatment with botulinum toxin type A (BoNT-A) for multiple sclerosis (MS)-related spasticity and the determinants of BoNT-A discontinuation in daily clinical setting. We retrospectively collected data of patients who started BoNT-A injections and underwent regular follow-up visits. Determinants of BoNT-A discontinuation were explored in a time-to-event Cox regression analysis which included as independent variables a large set of demographic and clinical characteristics. A total of 185 patients started BoNT-A injections from 2002 to 2014 and were followed up to September 2016. Of them, data on 121 were considered in our analysis. At follow-up, 53 (44%) patients were still on treatment and 68 (56%) patients discontinued BoNT-A after a median time of 1.2 years [interval 6 months to 7.4 years]. The reasons for discontinuation were loss of efficacy (n = 45), logistic problems or barriers to reach the structure (n = 16), and adverse events (n = 7). The absence of caregiver (hazard ratio = 1.69, p = 0.03) and lack of regular rehabilitation (hazard ratio = 1.78, p = 0.02) were two independent predictors for BoNT-A discontinuation. Our study confirms the beneficial effect of combining BoNT-A injections with rehabilitation and highlights the crucial role of caregivers for achieving better long-term outcomes in people with MS suffering from spasticity.
2017
botulinum toxin; multiple sclerosis; observational study; spasticity; treatment persistence; 2708; neurology (clinical); psychiatry and mental health
01 Pubblicazione su rivista::01a Articolo in rivista
Determinants of botulinum toxin discontinuation in multiple sclerosis. a retrospective study / Latino, Pamela; Castelli, Letizia; Prosperini, Luca; Marchetti, Maria Rita; Pozzilli, Carlo; Giovannelli, Morena. - In: NEUROLOGICAL SCIENCES. - ISSN 1590-1874. - 38:10(2017), pp. 1841-1848. [10.1007/s10072-017-3078-3]
File allegati a questo prodotto
File Dimensione Formato  
Latino_Determinants_2017.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 701.76 kB
Formato Adobe PDF
701.76 kB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1081757
Citazioni
  • ???jsp.display-item.citation.pmc??? 7
  • Scopus 13
  • ???jsp.display-item.citation.isi??? 12
social impact