{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T03:12:16Z","timestamp":1785726736396,"version":"3.56.0"},"reference-count":59,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100014382","name":"Ipsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100014382","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Objective<\/jats:title>\n                    <jats:p>Real\u2010world evidence describing long\u2010term persistency with botulinum toxin (BoNT) therapy is limited. We assessed treatment patterns and persistency with BoNT in clinical practice over 2\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective, longitudinal, claims database analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Medical claims data from the Merative MarketScan database in the United States.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants and Intervention<\/jats:title>\n                    <jats:p>Patients with an index medical claim for any BoNT therapy between October 1, 2016 and October 31, 2019, and at least 2 follow\u2010up years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes Measures<\/jats:title>\n                    <jats:p>\n                      Number of treatments, time between treatments, and persistency (based on a 120\u2010day look\u2010forward from treatment date) were evaluated over the 2\u2010year follow\u2010up period. Using the 120\u2010day look\u2010forward from treatment date, 31.1% of all patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919,711) received only one BoNT injection cycle in the 2\u2010year follow\u2010up, indicating a notable drop in the proportion of patients who persisted with BoNT treatment. This prompted further analysis of cohorts by indication: patients with adult spasticity (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091912), pediatric spasticity (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009638), stroke (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009611), cervical dystonia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009688), migraine (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097778), or bladder dysfunction (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091791) diagnoses. [Correction added on 02 April 2026, after first online publication: In the previous sentence, \u201cdecrease\u201d has been changed to \u201cdrop\u201d in this version.]\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A large proportion of patients treated with BoNT stopped after 1\u20132\u2009cycles. Across cohorts, the mean (SD) number of treatments administered was 2.1\u20134.7 (1.0\u20133.0). The time between treatments (80th percentile reported) ranged from 105\u2009days to 319\u2009days depending on the cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Increased understanding of BoNT treatment persistency in clinical practice is essential to help to optimize patient care. This study opens the discussion and field for future studies about why many patients discontinue BoNT therapy after only one or two treatment cycles. Further research will help to determine the underlying reasons for cessation of treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.70105","type":"journal-article","created":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T04:45:07Z","timestamp":1773290707000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Botulinum toxin use in patients with neurological disorders: A\n                    <scp>U.S.<\/scp>\n                    \u2010based claims database analysis"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2107-0203","authenticated-orcid":false,"given":"David M.","family":"Simpson","sequence":"first","affiliation":[{"name":"Department of Neurology Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Bouchard","sequence":"additional","affiliation":[{"name":"Ipsen  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Page","sequence":"additional","affiliation":[{"name":"Ipsen  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth","family":"Goldfarb","sequence":"additional","affiliation":[{"name":"Ipsen  Cambridge Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atul T.","family":"Patel","sequence":"additional","affiliation":[{"name":"Kansas City Bone &amp; Joint Clinic  Overland Park Kansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,11]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"AbbVie Ltd.BOTOX\u00ae Prescribing Information.2023. 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