Intravesical botulinum toxin‐A injections reduce bladder pain of interstitial cystitis/bladder pain syndrome refractory to conventional treatment – A prospective, multicenter, randomized, double‐blind, placebo‐controlled clinical trial

Kuo, Hann Chorng; Jiang, Yuan Hong; Tsai, Yao Chou; Kuo, Yuh Chen

doi:10.1002/nau.22760

Cited by 101 publications

(110 citation statements)

References 28 publications

(33 reference statements)

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“…Of the trials included, 4 reported BCG compared with placebo [32][33][34][35], 3 evaluated BoNTA in comparison with placebo [8,36,37], 2 reported RTX compared with placebo [38,39], 2 comparatively assessed chondroitin sulfate and placebo [7,40], 2 reported PPS compared with placebo [5,41], 1 evaluated lidocaine compared with placebo [42], 1 reported oxybutynin compared with placebo [43], and 1 assessed BCG in comparison with BoNTA [44]. The studies included assessed 905 patients in all.…”

Section: Resultsmentioning

confidence: 99%

“…One study had a three-arm design, and included 0.05 μM RTX, 0.1 μM RTX, and placebo control groups [38]; another study had a four-arm design, and included 0.01 μM RTX, 0.05 μM RTX, 0.1 μM RTX, and placebo control groups [39]. Five studies identified additional treatments in both groups, including hydrodistention [8,37], oral PPS [5,41], and antibiotics [45]. The shortest and longest follow-up times were 29 days and 24 months respectively (Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…We excluded non-RCTs with a high design bias, to increase the reliability of our research, because the treatment and outcome records of IC/PBS are subject to high subjectivity, especially pain and urgency records. We also updated the trials included to incorporate the most recently published review [8], and comparatively analyzed various intravesical treatments by network meta-analysis. However, Peeker et al's RCT comparing DMSO and BCG was finally excluded from both network and traditional meta-analyses in this study.…”

Section: Discussionmentioning

confidence: 99%

“…Current intravesical IC/PBS treatment strategies include botulinum toxin A (BoNTA), bacillus Calmette-Guerin (BCG), resiniferatoxin (RTX), lidocaine, chondroitin sulfate (CS), oxybutynin, and pentosan polysulfate (PPS) [7][8][9][10][11]. Previous studies demonstrated that these interventions can relieve the clinical symptoms of IC/PBS and restore bladder function; however, comparative efficacy among these drugs remains undetermined.…”

Section: Introductionmentioning

confidence: 99%

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Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

et al. 2016

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Introduction and hypothesis Interstitial cystitis/painful bladder syndrome (IC/PBS) is a chronic inflammatory condition of the submucosal and muscular layers of the bladder. So far, there is no effective and targeted treatment strategy for IC/ PBS. This study aimed to assess the efficacy and safety of intravesical instillation treatment in IC/PBS patients. Methods We searched various databases up to October 2015. A network meta-analysis was performed to compare global response assessment (GRA) for different treatment strategies, including botulinum toxin A (BoNTA), bacillus CalmetteGuerin (BCG), resiniferatoxin (RTX), lidocaine, chondroitin sulfate (CS), oxybutynin, and pentosan polysulfate (PPS). A traditional meta-analysis was also performed. Results Sixteen trials evaluating 905 patients were included. Network meta-analysis indicated that BoNTA had the highest probability of being the best treatment course according to GRA assessment results (probability 81.7 %). BCG or BoNTA therapy yielded significant improvement in GRA incidence according to traditional meta-analysis. Patients who received PPS showed higher urinary frequency results compared with the placebo groups. BCG-and PPS-treated patients had elevated urinary urgency treatment effects compared with placebo groups. Bladder capacity restoration results also showed significant improvements in patients who received BoNTA compared with placebo-treated individuals. Conclusions These findings indicate that BoNTA therapy has the highest probability of being the best therapy according to GRA, and significantly improves bladder capacity in IC/PBS patients. BCG treatment also significantly increases the incidence of GRA and improves the symptoms of urinary urgency. PPS can significantly improve urinary frequency and urgency symptoms in IC/PBS patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

et al. 2016

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“…Despite the same efficacy, an increase in the dysuria and PVR were more frequent in patients who received 200 IU BoNT-A. In a double-blind, placebo-controlled, multicentre study, Kuo et al (38) compared the effects of hydrodistension + 100 IU BoNT-A injections versus hydrodistension + saline injections on 67 patients. On the postoperative eighth week, there was a significant decrease in VAS (−2.6 vs. −0.9, p=0.02) and an increase in MCC (+67.8 vs. −45.4, p=0.020) compared to the placebo group.…”

Section: -Interstitial Cystitis/bladder Pain Syndromementioning

confidence: 99%

Use of botulinum toxin in urology: a literature review

Bayrak¹,

Şeçkiner²,

Onur³

et al. 2018

Eur J Ther

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Botulinum neurotoxin (BoNT) is currently preferred as a minimally invasive treatment for lower urinary tract pathologies. Although BoNT injections have become widespread globally for the past 5 years, today, the urological use of BoNT Type A (BoNT-A) is only licensed for the treatment of neurogenic detrusor overactivity and overactive bladder. Despite the relative evidence for the use of BoNT-A in benign prostatic enlargement, there is no high-level evidence data for the use in detrusor sphincter dyssynergia, interstitial cystitis/bladder pain syndrome, and chronic pelvic pain. In this comprehensive review, we mention the mechanism of action and efficacy of BoNT in various urological disorders, present the reliability, and evaluate the literature data supporting its use.

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Bilateral Thyroarytenoid Botulinum Toxin Type A Injection for the Treatment of Refractory Chronic Cough

Sasieta

Iyer

Orbelo

et al. 2016

JAMA Otolaryngol Head Neck Surg

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IMPORTANCERefractory chronic cough is a debilitating condition with limited therapeutic options. Laryngeal botulinum toxin type A (BtxA) has been anecdotally reported to benefit patients with chronic cough. We report on our experience with the use of BtxA for the treatment of patients with refractory chronic cough. MAIN OUTCOMES AND MEASURESThe primary outcome is a self-reported improvement of 50% or more in cough severity and/or symptoms by a 2-month follow-up telephone call. Adverse events and patient-reported quality measures were also assessed. RESULTS A total of 22 patients (median [interquartile range] age 61 [57.5-85] years; 19 of 22 women) underwent 31 distinct laryngeal BtxA treatment sessions. The primary outcome of self-reported improvement of 50% or more of cough severity and/or symptoms was achieved in 16 of 31 (52%) treatment sessions. Eleven patients (50%) reported greater than 50% improvement after the first BtxA injection. No major complications occurred. Postprocedural liquid dysphagia had a positive predictive value of 84% and negative predictive value of 100% for response to therapy.CONCLUSIONS AND RELEVANCE In this case series, laryngeal BtxA injection was well tolerated in patients with refractory chronic cough with half of participants experiencing at least short-term improvement in their cough. The occurrence of liquid dysphagia after a BtxA injection appeared to be predictive of a beneficial response. The durability of response, patient selection criteria, and optimal BtxA dosage remains to be determined.

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Intravesical botulinum toxin‐A injections reduce bladder pain of interstitial cystitis/bladder pain syndrome refractory to conventional treatment – A prospective, multicenter, randomized, double‐blind, placebo‐controlled clinical trial

Abstract: Intravesical injections of 100 U of BoNT-A effectively reduced bladder pain symptoms in patients with IC/BPS. The adverse events were acceptable. Neurourol. Urodynam. 35:609-614, 2016. © 2015 Wiley Periodicals, Inc.

Cited by 101 publications

References 28 publications

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

Intravesical treatment for interstitial cystitis/painful bladder syndrome: a network meta-analysis

Use of botulinum toxin in urology: a literature review

Bilateral Thyroarytenoid Botulinum Toxin Type A Injection for the Treatment of Refractory Chronic Cough

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