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Efficacy of Botulinum Toxin A Injection for Neurogenic Detrusor Overactivity and Urinary Incontinence: A Randomized, Double-Blind Trial

2011; Lippincott Williams & Wilkins; Volume: 185; Issue: 6 Linguagem: Inglês

10.1016/j.juro.2011.02.004

1527-3792

Sender Herschorn, Jerzy B. Gajewski, Karen Ethans, Jacques Corcos, Kevin Carlson, G Bailly, Robert Bard, Luc Valiquette, Richard Baverstock, Lesley K. Carr, Sidney B. Radomski,

Genital Health and Disease

No AccessJournal of UrologyAdult Urology1 Jun 2011Efficacy of Botulinum Toxin A Injection for Neurogenic Detrusor Overactivity and Urinary Incontinence: A Randomized, Double-Blind Trial Sender Herschorn, Jerzy Gajewski, Karen Ethans, Jacques Corcos, Kevin Carlson, Gregory Bailly, Robert Bard, Luc Valiquette, Richard Baverstock, Lesley Carr, and Sidney Radomski Sender HerschornSender Herschorn University of Toronto, Toronto, Ontario, Canada Financial interest and/or other relationship with Astellas, Allergan, Pfizer, Johnson&Johnson, Contura and Coloplast. More articles by this author , Jerzy GajewskiJerzy Gajewski Dalhousie University, Halifax, Nova Scotia, Canada Financial interest and/or other relationship with Astellas, Allergan, Medtronic, Lilly and Pfizer. More articles by this author , Karen EthansKaren Ethans University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author , Jacques CorcosJacques Corcos McGill University, Montreal, Quebec, Canada Financial interest and/or other relationship with Johnson&Johnson, Coloplast and Paladin. More articles by this author , Kevin CarlsonKevin Carlson University of Calgary, Calgary, Alberta, Canada Financial interest and/or other relationship with Health Education Limited Partnership, BR Capital, GlaxoSmithKline, Astellas and Pfizer. More articles by this author , Gregory BaillyGregory Bailly Dalhousie University, Halifax, Nova Scotia, Canada More articles by this author , Robert BardRobert Bard University of Manitoba, Winnipeg, Manitoba, Canada University of Calgary, Calgary, Alberta, Canada More articles by this author , Luc ValiquetteLuc Valiquette University of Montreal, Montreal, Quebec, Canada Financial interest and/or other relationship with Allergan, Astellas, Eli Lilly, GlaxoSmithKline, Pfizer, Cook and Olympus. More articles by this author , Richard BaverstockRichard Baverstock University of Manitoba, Winnipeg, Manitoba, Canada Financial interest and/or other relationship with Astellas, Pfizer and GlaxoSmithKline. More articles by this author , Lesley CarrLesley Carr University of Toronto, Toronto, Ontario, Canada Financial interest and/or other relationship with Cook Myosite, Astellas, Allergan and Pfizer. More articles by this author , and Sidney RadomskiSidney Radomski University of Toronto, Toronto, Ontario, Canada Financial interest and/or other relationship with Allergan, Pfizer, Lilly and Astellas. More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.004AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the efficacy of onabotulinumtoxinA for neurogenic detrusor overactivity secondary to spinal cord injury or multiple sclerosis. Materials and Methods: In a prospective, double-blind, multicenter study 57 patients 18 to 75 years old with neurogenic detrusor overactivity secondary to spinal cord injury or multiple sclerosis and urinary incontinence (defined as 1 or more occurrences daily) despite current antimuscarinic treatment were randomized to onabotulinumtoxinA 300 U (28) or placebo (29) via cystoscopic injection at 30 intradetrusor sites, sparing the trigone. Patients were offered open label onabotulinumtoxinA 300 U at week 36 and followed a further 6 months while 24 each in the treatment and placebo groups received open label therapy. The primary efficacy parameter was daily urinary incontinence frequency on 3-day voiding diary at week 6. Secondary parameters were changes in the International Consultation on Incontinence Questionnaire and the urinary incontinence quality of life scale at week 6. Diary and quality of life evaluations were also done after open label treatment. Results: The mean daily frequency of urinary incontinence episodes was significantly lower for onabotulinumtoxinA than for placebo at week 6 (1.31 vs 4.76, p <0.0001), and for weeks 24 and 36. Improved urodynamic and quality of life parameters for treatment vs placebo were evident at week 6 and persisted to weeks 24 to 36. The most common adverse event in each group was urinary tract infection. Conclusions: In adults with antimuscarinic refractory neurogenic detrusor overactivity and multiple sclerosis onabotulinumtoxinA is well tolerated and provides clinically beneficial improvement for up to 9 months. References 1 : Urinary incontinence in spinal cord injured individuals 10–45 years after injury. Spinal Cord2010; 48: 27. Google Scholar 2 : Urinary, faecal and sexual dysfunction in patients with multiple sclerosis. J Neurol1999; 246: 1027. Google Scholar 3 : Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. 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Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byTipton W, de Riese W and de Riese C (2020) Review of New Implantable Tibial Nerve Stimulators in Comparison to Established Third Line Treatment Modalities for Nonneurogenic Overactive BladderUrology Practice, VOL. 7, NO. 6, (530-537), Online publication date: 1-Nov-2020.Wein A (2019) Re: Switch to Abobotulinum Toxin A May be Useful in the Treatment of Neurogenic Detrusor Overactivity when Intradetrusor Injections of Onabotulinum Toxin A FailedJournal of Urology, VOL. 201, NO. 3, (451-452), Online publication date: 1-Mar-2019.Clemens J (2012) ConJournal of Urology, VOL. 187, NO. 6, (1963-1965), Online publication date: 1-Jun-2012. Volume 185Issue 6June 2011Page: 2229-2235 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsbotulinum toxin type Aurinary bladderspinal cord injuriesurinary incontinencemultiple sclerosisneurogenicAcknowledgmentsRandomization, monitoring, and data collection and analysis were done at Ethica Clinical Research. Sushma Soni, inScience Communications, and Dr. Sonja Dhani, Allergan, assisted with the manuscript.Metrics Author Information Sender Herschorn University of Toronto, Toronto, Ontario, Canada Financial interest and/or other relationship with Astellas, Allergan, Pfizer, Johnson&Johnson, Contura and Coloplast. More articles by this author Jerzy Gajewski Dalhousie University, Halifax, Nova Scotia, Canada Financial interest and/or other relationship with Astellas, Allergan, Medtronic, Lilly and Pfizer. More articles by this author Karen Ethans University of Manitoba, Winnipeg, Manitoba, Canada More articles by this author Jacques Corcos McGill University, Montreal, Quebec, Canada Financial interest and/or other relationship with Johnson&Johnson, Coloplast and Paladin. More articles by this author Kevin Carlson University of Calgary, Calgary, Alberta, Canada Financial interest and/or other relationship with Health Education Limited Partnership, BR Capital, GlaxoSmithKline, Astellas and Pfizer. More articles by this author Gregory Bailly Dalhousie University, Halifax, Nova Scotia, Canada More articles by this author Robert Bard University of Manitoba, Winnipeg, Manitoba, Canada University of Calgary, Calgary, Alberta, Canada More articles by this author Luc Valiquette University of Montreal, Montreal, Quebec, Canada Financial interest and/or other relationship with Allergan, Astellas, Eli Lilly, GlaxoSmithKline, Pfizer, Cook and Olympus. More articles by this author Richard Baverstock University of Manitoba, Winnipeg, Manitoba, Canada Financial interest and/or other relationship with Astellas, Pfizer and GlaxoSmithKline. More articles by this author Lesley Carr University of Toronto, Toronto, Ontario, Canada Financial interest and/or other relationship with Cook Myosite, Astellas, Allergan and Pfizer. More articles by this author Sidney Radomski University of Toronto, Toronto, Ontario, Canada Financial interest and/or other relationship with Allergan, Pfizer, Lilly and Astellas. More articles by this author Expand All Advertisement PDF downloadLoading ...