OBJECTIVES

Botulinum toxin-A (BoNT-A) is an established treatment option for focal spasticity but the effects of BoNT-A diminish towards the end of a treatment cycle. We aimed to evaluate the impact of spasticity and the impact of symptom re-emergence on patients’ employment, comparing results from the United States (US) versus Europe (EU).

METHODS

Online patient survey to capture the treatment experiences of adults with spasticity. Eligible respondents had ≥2 previous BoNT-A treatments. The survey was deployed in the US & EU (Italy, France, Germany and United Kingdom). Analyses were descriptive.

RESULTS

Data from 210 respondents (US=105, EU=105, mean age 47.2 years, 53% male, stroke 43%/ TBI 30%/ SCI 27%) were analyzed. Overall, 78% of respondents were employed. Symptom re-emergence between BoNT-A injections was common (82 & 84%), with significant impact on quality of life. Working respondents in US were more likely to report ‘work inefficiency’ (51% vs 39% in EU) and having to ‘work from home’ (27% vs 8% in EU), while more EU respondents said they had to ‘take time off work’ (53% vs 41% in US). Respondents in both regions rated their spasticity as having small impact on their ability to perform daily tasks at peak treatment effect (1.8/10 in US & 1.9/10 in EU, where 10=very strong impact) but strong impact at the end of the injection cycle (6.2/10 & 6.7/10, respectively).

CONCLUSIONS

Our survey sample was noticeably younger (mean age 47.2 years) than epidemiological data, and consequently, the proportion working was higher than expected. However, the impact on those respondents who do work was striking – up to half said they have to take time off work when the symptoms re-emerge and a similar proportion reported a loss of efficiency. There were subtle differences between the US and EU experience, but inconclusive without statistical analysis.