These and other outcomes for effectiveness of BTX-A at different dosages in two observation periods indicate that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo .
However , there were no significant differences between some dosages .
Compared with placebo , the outcomes of total adverse events for NDO and for IDO show that doses of 300 U and 200 U for NDO are associated with more complications .
Conclusions In consideration that the treatments of BTX-A were with minimal , local , and manageable adverse effects , this meta- analysis demonstrates that BTX-A 200 U is recommended for management of NDO for short-term treatment for there was no significant difference from the larger dose of 300U .
Purpose To assess the effectiveness and safety of botulinum toxin A ( BTX-A ) at different dosages for overactive bladder ( OAB ) .
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.
BACKGROUND In the treatment of patients with idiopathic overactive bladder ( iOAB ) , high doses of botulinum toxin type A ( BoNTA ) were often associated with complications result ing from high postvoid residuals ( PVR ) , leading to clean intermittent catheterisation ( CIC ) and urinary tract infections ( UTI ) . OBJECTIVE Evaluate the efficacy and tolerability of low doses of onabotulinumtoxinA compared to placebo in patients with iOAB . DESIGN , SETTING , AND PARTICIPANTS Between 2005 and 2009 , adults with persistent iOAB were included in a prospect i ve , r and omised , double-blind , placebo-controlled comparative trial . INTERVENTION Patients were r and omised to undergo a single intradetrusor injection procedure of either placebo or onabotulinumtoxinA ( 50 U , 100 U or 150 U ) . MEASUREMENTS The initial evaluations ( ie , clinical and urodynamic variables as well as quality of life [ QoL ] ) were repeated at day 8 and months 1 , 3 , 5 , and 6 . RESULTS AND LIMITATIONS Ninety-nine patients were included in the efficacy analysis . Three months after the procedure , we observed>50 % improvement versus baseline in urgency and urge urinary incontinence ( UUI ) in 65 % and 56 % of patients who respectively received 100 U ( p=0.086 ) and 150 U ( p=0.261 ) BoNTA injections and > 75 % improvement in 40 % of patients of both groups ( 100 U [ p=0.058 ] and 150 U [ p=0.022 ] ) . Complete continence was observed in 55 % and 50 % patients after 100 U and 150 U BoNTA treatment , respectively , at month 3 . Frequency symptoms and QoL improved up to the 6-mo visit . We observed only three patients with a PVR>200 ml in the 150 U group and a few UTIs . CONCLUSIONS 100 U and 150 U BoNTA injections were well tolerated and have both shown to improve symptoms and QoL in patients with iOAB . Nevertheless , 100 U injections showed a reasonable efficacy , with a lower risk of high PVR . TRIAL REGISTRATION Clinical Trials.gov NCT00231491
These and other outcomes for effectiveness of BTX-A at different dosages in two observation periods indicate that a dose greater than 50 U is significantly more effective for certain symptoms of OAB compared with placebo .
However , there were no significant differences between some dosages .
Compared with placebo , the outcomes of total adverse events for NDO and for IDO show that doses of 300 U and 200 U for NDO are associated with more complications .
Conclusions In consideration that the treatments of BTX-A were with minimal , local , and manageable adverse effects , this meta- analysis demonstrates that BTX-A 200 U is recommended for management of NDO for short-term treatment for there was no significant difference from the larger dose of 300U .
Purpose To assess the effectiveness and safety of botulinum toxin A ( BTX-A ) at different dosages for overactive bladder ( OAB ) .