PMID- 23775527
OWN - NLM
STAT- MEDLINE
DCOM- 20140122
LR  - 20211021
IS  - 1179-1950 (Electronic)
IS  - 0012-6667 (Linking)
VI  - 73
IP  - 10
DP  - 2013 Jul
TI  - Efficacy and safety of botulinum toxin A intradetrusor injections in adults with 
      neurogenic detrusor overactivity/neurogenic overactive bladder: a systematic 
      review.
PG  - 1055-66
LID - 10.1007/s40265-013-0068-5 [doi]
AB  - BACKGROUND: Botulinum toxin A (BoNTA) is increasingly used for therapy of 
      neurogenic detrusor overactivity (NDO) refractory to antimuscarinics or where 
      patients are experiencing antimuscarinic-related side effects. OBJECTIVE: The 
      objective was to compare and critically discuss the reported efficacy and safety 
      of BoNTA in adults with neurogenic bladder dysfunction. DATA SOURCES: Studies 
      published between January 1985 and July 2012 were identified in the MEDLINE 
      (PubMed) and SCOPUS databases. STUDY SELECTION, STUDY APPRAISAL AND SYNTHESIS 
      METHODS: A search for studies with onabotulinumtoxinA--the only formulation of 
      BoNTA approved by the US FDA in adults with NDO--was performed. Exclusion 
      criteria were urethral sphincter injection, no separate analysis between 
      onabotulinumtoxinA and other formulations of BoNTA, mean follow-up </= 4 weeks and 
      studies with ten or fewer patients. Clinical and urodynamic parameters for 
      efficacy, adverse events (AEs) and tolerability were reviewed to offer 
      recommendations for practice and future research. RESULTS: A total of 28 included 
      studies revealed superior effects of onabotulinumtoxinA compared with placebo in 
      achieving continence, reducing incontinence episodes, improving urodynamic 
      parameters and health-related quality of life. The most frequently reported AEs 
      were de novo intermittent catheterization, urinary retention and asymptomatic 
      urinary infection. LIMITATIONS: Limitations of this review are the inclusion of 
      studies with the level-3 evidence (22/28 studies), the heterogenicity of outcome 
      parameters and time points chosen for follow-up reported in the reviewed studies. 
      CONCLUSIONS: OnabotulinumtoxinA therapy is effective, safe and well tolerated in 
      adults with neurogenic bladder dysfunction. Further high-quality prospective 
      trial data are required to determine the optimal dose, injection technique, 
      long-term safety, favourable timing, indications for re-injections, and the 
      impact of concomitant antimuscarinics on onabotulinumtoxinA therapy.
FAU - Soljanik, Irina
AU  - Soljanik I
AD  - Neuro-Urology, Spinal Cord Injury Center, Heidelberg University Hospital, 
      Schlierbacher Landstrasse 200a, 69118 Heidelberg, Germany. irasol@hotmail.com
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
PL  - New Zealand
TA  - Drugs
JT  - Drugs
JID - 7600076
RN  - 0 (Neuromuscular Agents)
RN  - EC 3.4.24.69 (Botulinum Toxins, Type A)
SB  - IM
MH  - Botulinum Toxins, Type A/*administration & dosage/adverse effects
MH  - Humans
MH  - Injections/methods
MH  - Neuromuscular Agents/*administration & dosage/adverse effects
MH  - Treatment Outcome
MH  - Urinary Bladder, Neurogenic/*drug therapy
MH  - Urinary Bladder, Overactive/*drug therapy
EDAT- 2013/06/19 06:00
MHDA- 2014/01/23 06:00
CRDT- 2013/06/19 06:00
PHST- 2013/06/19 06:00 [entrez]
PHST- 2013/06/19 06:00 [pubmed]
PHST- 2014/01/23 06:00 [medline]
AID - 10.1007/s40265-013-0068-5 [doi]
PST - ppublish
SO  - Drugs. 2013 Jul;73(10):1055-66. doi: 10.1007/s40265-013-0068-5.