Efficacy Of OnabotulinumtoxinA In Patients Research Articles

The efficacy of onabotulinumtoxinA in patients with previous failed augmentation cystoplasty: Cohort series and literature review.

To investigate the role of onabotulinumtoxinA (BTX-A) injections in patients with failed augmentation cystoplasty for neuropathic or idiopathic detrusor overactivity (NDO or IDO). A retrospective review of all cystoplasty patients who underwent onabotulinumtoxinA injection at a tertiary center between 2008 and 2019 was performed. Details including indications and time from cystoplasty, video-urodynamic parameters, onabotulinumtoxinA dose, and clinical outcomes were analyzed. Telephone interview was performed for patients that requested repeat onabotulinumtoxinA injections. The interview included a modified PGIC7 and UDI6 questionnaires. A positive clinical response was considered improvement of overactive symptoms sufficient to merit repeat onabotulinumtoxinA injection and a modified PGIC7 of four or above. Thirty patients were identified (11 men and 19 women). The indications for augmentation were IDO (n = 18) or NDO (n = 12). Mean age at the time of cystoplasty was 42 years (range, 10-61). Interval between cystoplasty and initial onabotulinumtoxinA was 98 months (range, 3-271). Video-urodynamics before onabotulinumtoxinA revealed low compliance in 13 patients, DO in 22 patients, and combined low compliance/DO in 10. The median maximum cystometric bladder capacity was 338 mL (range, 77-570 mL). Thirteen patients responded to onabotulinumtoxinA injections. Higher peak DO pressure was associated with a significantly higher chance that the patient would experience benefit from the injections P = .026). The patients that responded to onabotulinumtoxin A underwent a total of 115 procedures (mean, 8.8 injections) over a mean 88 months (range, 20-157 months). Forty-three percent of patients responded well to intra-detrusor onabotulinumtoxinA injections. This avoided the need for more invasive surgery and had a positive impact on their quality of life.

Addendum: Long-term Treatment Benefits and Prolonged Efficacy of OnabotulinumtoxinA in Patients Affected by Chronic Migraine and Medication Overuse Headache over 3 Years of Therapy

Addendum: Long-term Treatment Benefits and Prolonged Efficacy of OnabotulinumtoxinA in Patients Affected by Chronic Migraine and Medication Overuse Headache over 3 Years of Therapy

Long-term Treatment Benefits and Prolonged Efficacy of OnabotulinumtoxinA in Patients Affected by Chronic Migraine and Medication Overuse Headache over 3 Years of Therapy.

Chronic migraine (CM) affects about the 2% of the general population and it has been recognized as one of the most-disabling conditions worldwide by the World Health Organization. CM is often associated with the overuse of abortive medication, which determines the worsening of headache itself and the development of a secondary headache called medication overuse headache. The management of these associated conditions is difficult, but a growing amount of evidence is pointing out the effectiveness and the good safety profile of OnabotulinumtoxinA (OnabotA). Despite this, data on OnabotA effects and safety in long-term use lack. The purpose of the present article is to retrospectively assess the efficacy and safety of OnabotA in a cohort of chronic migraineurs with drug overuse from the 18th month of treatment until the third year. 90 chronic migraineurs with medication overuse were enrolled between January 2013 and February 2017. All patients were treated with OnabotA according to PREEMPT dictates. Before every injection session the headache index, the analgesic consumption, the visual analog scale for pain score, the 36-items short form health survey questionnaire score, the 6-items headache impact test (HIT-6) score and the Zung self-rating anxiety and depression scale scores were collected. Adverse events were carefully registered. A simple linear regression was performed to explore the mean changes in the abovementioned parameters for a single injection session and mean comparison tests were performed using the one-way analysis of variance followed by Tukey-Kramer post-hoc test. A significantly improvement for a single injection was registered for all the above-mentioned parameters. Headache index, analgesic consumption, visual analog pain scale, and 6-items HIT-6 scores were significantly lower than baseline from the 18th month of treatment onwards. The 36-items short form health survey questionnaire scores were significantly higher than baseline at every injections session from the 18th months onwards. Zung scales did not change. No serious adverse events were assessed and no adverse events-related drop-outs were seen. OnabotA effectiveness and safety last until 3 years of therapy, raising the possibility of the use of this therapy even for many years in CM prevention.

1517 EFFICACY OF ONABOTULINUMTOXINA IN PATIENTS WITH NEUROGENIC BLADDER AND DECREASED BLADDER COMPLIANCE

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Neurogenic Voiding Dysfunction1 Apr 20111517 EFFICACY OF ONABOTULINUMTOXINA IN PATIENTS WITH NEUROGENIC BLADDER AND DECREASED BLADDER COMPLIANCE Laura Mengheang, John Hairston, and Christopher Smith Laura MengheangLaura Mengheang Houston, TX More articles by this author , John HairstonJohn Hairston Chicago, IL More articles by this author , and Christopher SmithChristopher Smith Houston, TX More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1496AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Intradetrusor injection of botulinum toxin type A (BoNT-A) has previously been shown to be a safe and efficacious treatment for patients with neurogenic detrusor overactivity and normal bladder compliance. In this study, we examined the efficacy of BoNT-A injection in patients with neurogenic bladder due to spinal cord injury, most of whom had decreased detrusor compliance at baseline. METHODS Data were collected retrospectively from 24 patients with urinary incontinence secondary to spinal cord injury, each of whom underwent intradetrusor injection of 300 units of onabotulinumtoxinA (onaBoNT-A) (except 100 units in one case). Urodynamics were conducted at baseline and at mean of 2.5 months post-injection, and data were analyzed by paired t-test. Normal compliance was defined as >20 ml/cm H2O. Favorable clinical response was defined as decrease in frequency of catheterization and/or absence of incontinence episodes. RESULTS Eighteen of 24 patients (75%) reported a favorable clinical response. Overall, there was a significant improvement in urodynamic parameters after onaBoNT-A injection. Seventeen of the 22 patients who had decreased baseline compliance had improvement of compliance, 12 of whom had improvement into the normal range after onaBoNT-A injection (baseline 11.2 + 1 ml/cm H2O, post-treatment 29.2 + 5 ml/cm H2O). Eleven of these 12 patients (92%) also had a favorable clinical response. Furthermore, eighteen of the 24 patients had an elevated maximum detrusor pressure (> 40 cm H2O) with improvement of maximum pressure below 40 cm H2O after onaBoNT-A in 9/18, all of whom had good clinical response. CONCLUSIONS In patients with neurogenic bladder and impaired baseline compliance, intradetrusor onaBoNT-A injections can improve bladder compliance into the normal range (>20 ml/cm). OnaBoNT-A also had a similar effect on reducing maximum detrusor pressure in these patients. This is the largest study to date examining the efficacy of intradetrusor onaBoNT-A injection in patients with neurogenic bladder and decreased compliance. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e608 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Laura Mengheang Houston, TX More articles by this author John Hairston Chicago, IL More articles by this author Christopher Smith Houston, TX More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...