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 ) .
OnabotulinumtoxinA improves quality of life in patients with neurogenic detrusor overactivity
Objective : To evaluate the effects of onabotulinumtoxinA on patient-reported outcomes including health-related quality of life ( HRQOL ) , treatment satisfaction , and treatment goal attainment in patients with urinary incontinence ( UI ) due to neurogenic detrusor overactivity ( NDO ) . Methods : In this multicenter , double-blind , r and omized , placebo-controlled , phase III , 52-week study ( Clinical Trials.gov NCT00311376 ) , patients with UI due to NDO who were not adequately managed with anticholinergic therapy were treated with intradetrusor injections of onabotulinumtoxinA ( 200 or 300 U ) or placebo ( 0.9 % saline ) . HRQOL measures included the Incontinence Quality of Life ( I-QOL ) Question naire total score , and the 3 domain scores ( avoidance and limiting behavior , psychosocial , and social embarrassment ) , the modified Overactive Bladder Patient Satisfaction with Treatment Question naire ( OAB-PSTQ ) , and Patient Global Assessment . Assessment s were made at baseline , posttreatment week 6 ( primary time point ) , week 12 , and at 12-week intervals . Results : Patients ( mean age of 46 years with 30.5 weekly UI episodes at baseline ) were r and omized to receive placebo ( n = 149 ) or onabotulinumtoxinA ( 200 U [ n = 135 ] or 300 U [ n = 132 ] ) . At week 6 , improvements from baseline in I-QOL Question naire total score were greater ( p < 0.001 ) in both onabotulinumtoxinA-treated groups vs placebo . Responses to the OAB-PSTQ also demonstrated greater mean improvements from baseline ( p < 0.001 ) in both onabotulinumtoxinA-treated groups vs placebo at week 6 . Patients who received onabotulinumtoxinA also reported greater improvement in the Patient Global Assessment than those in the placebo group ( p ≤ 0.001 vs placebo ) . Conclusions : Patients with UI due to NDO reported greater improvement in HRQOL and treatment satisfaction with onabotulinumtoxinA than with placebo consistently across several patient-reported outcome instruments . Classification of evidence : This study provides Class I evidence that onabotulinumtoxinA intradetrusor injections ( 200 or 300 U ) can improve quality of life measures in patients with NDO not adequately managed with anticholinergic therapy
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 ) .