Efficacy and Safety of Low Doses of OnabotulinumtoxinA for the Treatment of Refractory Idiopathic Overactive Bladder: A Multicentre, Double-Blind, Randomised, Placebo-Controlled Dose-Ranging Study

Denys, Pierre; Normand, L. Le; Ghout, Idir; Costa, P.; Chartier‐Kastler, Emmanuel; Grise, P.; Hermieu, Jean-François; Amarenco, G.; Karsenty, G.; Saussine, C.; Barbot, Frédéric

doi:10.1016/j.eururo.2011.10.028

Cited by 147 publications

(160 citation statements)

References 23 publications

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“…With this dose the response rate (in the reports usually defined as >50% improvement or 'improved' or 'greatly improved' on Treatment Benefit Scales) is in excess of 60% in most studies (range 37-70%), typically with a 20-50% reduction in incontinence episodes (i.e. about 3 fewer leaks per 24 hours), 23-55% of patients achieving continence, and statistically significant improvement in quality of life measures [2][3][4][6][7][8] (Table 3). The response rate in our study is somewhat lower at 43% at one month and 36% at three months, and while there was statistically significant reduction in incontinence episodes (p=0.01) and leakage (p=0.025), the numbers are lower than those reported after cystoscopic injection.…”

Section: Comparison With Cystoscopic Injectionmentioning

confidence: 99%

“…2-3 fewer leaks per 24 hours), 23-55% of patients achieving continence, and a statistically significant improvement in quality of life measures [2][3][4][6][7][8] . The main complications are a 5-36% risk of UTI [2][3][4][5][6]9] and a 4-11% risk of impaired bladder emptying requiring catheterization [1,3,4,6,9] . Some patients also experience postoperative pain and dysuria.…”

Section: Introductionmentioning

confidence: 99%

“…Management of overactive bladder (OAB) can be difficult, and when primary treatment has failed to give sufficient improvement, cystoscopic injection of botulinum toxin into the bladder wall is now a well established treatment option [1][2][3][4] . This is a minimally invasive outpatient or day case procedure.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intravesical Electromotive Botulinum Toxin in Women with Overactive Bladder – A Pilot Study

2017

ARC Journal of Gynecology and Obstetrics

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Section: Comparison With Cystoscopic Injectionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Intravesical Electromotive Botulinum Toxin in Women with Overactive Bladder – A Pilot Study

2017

ARC Journal of Gynecology and Obstetrics

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“…Only 3 RCTs were included in their review. Since the publication of their review, various new RCTs have been published which included many large sample size studies about botulinum toxin used for idiopathic OAB [6,7,8,9,10,11]. In this paper, we attempt to summarize the data from all RCTs to assess the efficacy and safety of botulinum toxin-A in the management of idiopathic OAB.…”

Section: Introductionmentioning

confidence: 99%

Botulinum Toxin-A Injections for Idiopathic Overactive Bladder: A Systematic Review and Meta-Analysis

Yu¹,

Wang²,

Liu³

et al. 2013

Urol Int

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Objective: To review the current evidence on the efficacy and safety of botulinum toxin-A in the management of idiopathic overactive bladder (OAB). Methods: A systematic search of PubMed, Embase and the Cochrane Central Search Library was performed. All randomized controlled trials comparing botulinum toxin-A with placebo, different doses and injection techniques, in patients with idiopathic OAB was included. The analyzed outcomes were quantification of symptoms, urodynamic outcomes, quality of life and adverse events. Result: A total of 1,020 participants from 12 randomized controlled trials were included. Botulinum toxin-A was associated with less urinary frequency, less incontinence episodes, improvement in quality of life, higher post-void residual-related catheterization and higher urinary tract infection. Doses of 100-300 U were not consistently differentiated from each other in voiding diary, quality of life and urge urinary incontinence. No statistically significant difference was seen between bladder body and bladder base, bladder body and bladder body plus trigone in urinary retention and urinary tract infection. Conclusion: Botulinum toxin-A is associated with significant improvement in OAB symptoms in patients with idiopathic OAB. However, there is a higher incidence of postoperative urinary retention and urinary infection compared to placebo. Low-dose botulinum toxin-A seems to be the optimum dose that appropriately balances the benefits with adverse events. Trigone inclusion seems as safe and effective as trigone-sparing injection.

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“…2 These guidelines are based on high-quality, randomized controlled trials (RCTs) that have been published in the recent past. [1][2][3][4][5] Meta-analyses of these RCTs report significant improvements in OAB-related outcomes, including incontinence, urodynamics, and patient-reported outcomes (PROs), along with few adverse events. [6][7][8] One such review outlines that 60-65% of patients injected at a 100 U dose reported improvements in urgency incontinence, symptom scores, and quality of life.…”

Section: Introductionmentioning

confidence: 99%

OnabotulinumtoxinA for the treatment of idiopathic overactive bladder is effective and safe for repeated use

Carlson

Civitarese

Baverstock

2017

CUAJ

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Introduction: The objective of this study was to compare efficacy and safety outcomes between patients receiving onabotulinumtoxinA (OnabotA) for the first time and those receiving a repeat injection. Methods: Data collected before and after OnabotA injection were extracted from a clinical registry. Patients were classified into either first or repeat injection subgroups. Efficacy was measured by the change in use of oral bladder medications, the number of voids per day or night, the frequency of urinary incontinence (UI) episodes, and patient-reported outcomes. Safety was measured by the number of self-reported complications. Differences in safety measures between the subgroups were tested. Results: The analysis included complete data from 81 patients; 30 (37%) receiving OnabotA for the first time, 51 (63%) receiving a repeat injection. Both subgroups reported significant reductions in the use of anticholinergics, more tolerable bladder symptoms, and improvements in patient-reported outcomes. Dry rates were similarly high in both groups (50% and 43%, respectively). There were no statistically significant differences between the subgroups in terms of their safety outcomes. Conclusions: OnabotA is equally as efficacious and safe for patients with overactive bladder receiving a repeat injection as it is for those receiving their first injection.

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Efficacy and Safety of Low Doses of OnabotulinumtoxinA for the Treatment of Refractory Idiopathic Overactive Bladder: A Multicentre, Double-Blind, Randomised, Placebo-Controlled Dose-Ranging Study

Cited by 147 publications

References 23 publications

Intravesical Electromotive Botulinum Toxin in Women with Overactive Bladder – A Pilot Study

Intravesical Electromotive Botulinum Toxin in Women with Overactive Bladder – A Pilot Study

Botulinum Toxin-A Injections for Idiopathic Overactive Bladder: A Systematic Review and Meta-Analysis

OnabotulinumtoxinA for the treatment of idiopathic overactive bladder is effective and safe for repeated use

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