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Switch to Abobotulinum toxin A may be useful in the treatment of neurogenic detrusor overactivity when intradetrusor injections of Onabotulinum toxin A failed
Author(s) -
Bottet Florie,
Peyronnet Benoit,
Boissier Romain,
Reiss Bénédicte,
Previnaire Jean G.,
Manunta Andrea,
Kerdraon Jacques,
Ruffion Alain,
Lenormand Loïc,
Perrouin Verbe Brigitte,
Gaillet Sarah,
Gamé Xavier,
Karsenty Gilles
Publication year - 2018
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23291
Subject(s) - medicine , refractory (planetary science) , botulinum toxin , adverse effect , urology , anesthesia , urinary incontinence , urinary system , physics , astrobiology
Aims To assess the outcomes of switching to a different brand of botulinum toxin A (BTA, from Botox® to Dysport®) in case of failure of intradetrusor injections (IDI) of Botox® in the treatment of neurogenic detrusor overactivity (NDO). Methods The charts of all patients who underwent a switch to IDI of Dysport® after failure of an IDI of Botox® at six departments of neurourology were retrospectively reviewed. The main outcomes of interest were the bladder diary data and four urodynamic parameters: maximum cystometric capacity (MCC), maximum detrusor pressure (PDET max), and volume at first uninhibited detrusor contraction (UDC). Results Fifty‐seven patients were included. After the first injection of Dysport®, no adverse events were reported. A significant decrease in number of urinary incontinence episodes per day was observed in 52.63% of patients ( P < 0.001) and all patients experienced a reduction in PDET Max (−8.1 cmH20 on average; P = 0.003). MCC significantly increased by a mean of 41.2 ( P = 0.02). The proportion of patients with no UDC increased significantly at week 6 after ATA injections (from 15.79% to 43.9%; P = 0.0002). Hence, 32 patients draw clinical and/or urodynamic benefits from the botulinum toxin switch from (56.14%). After a median follow up of 21 months, 87% of responders to BTA switch were still treated successfully with BTA. Conclusion Most patients refractory to Botox® (56.14%) draw benefits from the switch to Dysport®.