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 ) .
Urodynamic results and clinical outcomes with intradetrusor injections of onabotulinumtoxinA in a randomized, placebo-controlled dose-finding study in idiopathic overactive bladder.
AIMS We assessed the effects of onabotulinumtoxinA ( BOTOX ® ) on clinical and urodynamic variables in patients with idiopathic overactive bladder ( OAB ) and urinary urgency incontinence ( UUI ) with or without detrusor overactivity ( DO ) , inadequately managed with anticholinergics . METHODS Three hundred thirteen patients with OAB were r and omized to double-blind intradetrusor injection with placebo ( n = 44 ) or 1 of 5 onabotulinumtoxinA doses ( 50 - 300 U ; n = 269 ) . Primary efficacy variable was change from baseline in UUI episodes/week at week 12 . Urodynamic assessment s at baseline and weeks 12 and 36 included maximum cystometric capacity ( MCC ) and volume at first involuntary detrusor contraction ( IDC ) . RESULTS 76.0 % of patients had baseline DO . Changes from baseline in MCC and volume at first IDC with onabotulinumtoxinA ≥100 U were superior to placebo at week 12 , generally decreasing by week 36 . Significant dose-dependent increases in MCC were observed for all onabotulinumtoxinA doses at week 12 , and for 150 , 200 , and 300 U at week 36 . Data suggested a dose-response relationship . At week 12 on diary , 15.9 % of placebo and 29.8 - 57.1 % of onabotulinumtoxinA 50 - 300 U recipients , respectively , did not demonstrate UUI . OnabotulinumtoxinA doses > 150 U were more commonly associated with post-void residual urine volumes > 200 ml . CONCLUSIONS Improvements in urodynamic parameters and clinical outcomes generally trended together following onabotulinumtoxinA treatment . This therapy improved key urodynamic parameters in patients with idiopathic OAB and UUI , with no differences in outcomes between those with and those without baseline DO . Therefore , successful idiopathic OAB treatment with onabotulinumtoxinA does not appear to be related to pretreatment finding of DO
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 ) .