Browse > Article
http://dx.doi.org/10.5213/inj.1836118.059

Efficacy and Safety of OnabotulinumtoxinA in Patients With Neurogenic Detrusor Overactivity Caused by Spinal Cord Injury: A Systematic Review and Meta-Analysis  

Li, Guang-Ping (Department of Urology, Beijing Tian Tan Hospital, Capital Medical University)
Wang, Xiao-Yan (Department of Urology, Beijing Tian Tan Hospital, Capital Medical University)
Zhang, Yong (Department of Urology, Beijing Tian Tan Hospital, Capital Medical University)
Publication Information
International Neurourology Journal / v.22, no.4, 2018 , pp. 275-286 More about this Journal
Abstract
Purpose: OnabotulinumtoxinA (BoNT-A) is a promising therapy for treating neurogenic detrusor overactivity (NDO) in individuals with spinal cord injury (SCI). This systematic review and meta-analysis aimed to carry out an in-depth review and to make an objective estimation of the efficacy and safety of BoNT-A on NDO after SCI. Methods: The PubMed, Embase, and Cochrane databases were searched for all relevant articles published from 2001 to 2016 that referred to NDO, SCI, and BoNT-A or botulinum toxin A. All data were recorded in an Excel spreadsheet by 2 individual reviewers. Review Manager version 5.3 was used to carry out the meta-analysis. Results: This analysis included 17 studies involving 1,455 patients. Compared with placebo and baseline, BoNT-A was effective in increasing maximum cystometric capacity, volume at first involuntary detrusor contraction, cystometric bladder capacity (all P<0.00001), compliance (P=0.001), and the number of patients with complete dryness (P=0.0003), and decreasing detrusor pressure, the number of patients with no involuntary detrusor contractions, the maximum flow rate, the incidence of detrusor overactivity (all P<0.00001), and the number of urinary incontinence episodes (P=0.001). There were no statistically significant differences between doses of 200 U and 300 U or between injections into the detrusor and submucosa. There were no life-threatening adverse events. Conclusions: BoNT-A is effective and safe in treating NDO after SCI. There were no statistically significant differences between doses of 200 U and 300 U or between injecting into the detrusor and submucosa. However, more high-quality randomized controlled trials are still needed.
Keywords
OnabotulinumtoxinA; Meta-analysis; Neurogenic detrusor overactivity; Spinal cord injury;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Leitner L, Walter M, Freund P, Mehnert U, Michels L, Kollias S, et al. Protocol for a prospective magnetic resonance imaging study on supraspinal lower urinary tract control in healthy subjects and spinal cord injury patients undergoing intradetrusor onabotulinumtoxinA injections for treating neurogenic detrusor overactivity. BMC Urol 2014;14:68.   DOI
2 Tetreault LA, Karadimas S, Wilson JR, Arnold PM, Kurpad S, Dettori JR, et al. The natural history of degenerative cervical myelopathy and the rate of hospitalization following spinal cord injury: an updated systematic review. Global Spine J 2017;7(3 Suppl):28S-34S.
3 Linsenmeyer TA. Use of botulinum toxin in individuals with neurogenic detrusor overactivity: state of the art review. J Spinal Cord Med 2013;36:402-19.   DOI
4 Yan HL, Zong HT, Cui YS, Li N, Zhang Y. Calcineurin inhibitor avoidance and withdrawal for kidney transplantation: a systematic review and meta-analysis of randomized controlled trials. Transplant Proc 2014;46:1302-13.   DOI
5 Ginsberg D, Cruz F, Herschorn S, Gousse A, Keppenne V, Aliotta P, et al. OnabotulinumtoxinA is effective in patients with urinary incontinence due to neurogenic detrusor overactivity [corrected] regardless of concomitant anticholinergic use or neurologic etiology. Adv Ther 2013;30:819-33.   DOI
6 Jia C, Liao LM, Chen G, Sui Y. Detrusor botulinum toxin A injection significantly decreased urinary tract infection in patients with traumatic spinal cord injury. Spinal Cord 2013;51:487-90.   DOI
7 Sengoku A, Okamura K, Kimoto Y, Ogawa T, Namima T, Yamanishi T, et al. Botulinum toxin A injection for the treatment of neurogenic detrusor overactivity secondary to spinal cord injury: multiinstitutional experience in Japan. Int J Urol 2015;22:306-9.   DOI
8 Ginsberg D, Gousse A, Keppenne V, Sievert KD, Thompson C, Lam W, et al. Phase 3 efficacy and tolerability study of onabotulinumtoxinA for urinary incontinence from neurogenic detrusor overactivity. J Urol 2012;187:2131-9.   DOI
9 Chen SF, Chang CH, Kuo HC. Clinical efficacy and changes of urothelial dysfunction after repeated detrusor botulinum toxin A injections in chronic spinal cord-injured bladder. Toxins (Basel) 2016 May 30;8(6). pii: E164. https://doi.org/10.3390/toxins8060164.
10 Hui C, Keji X, Chonghe J, Ping T, Rubiao O, Jianweng Z, et al. Combined detrusortrigone BTX-A injections for urinary incontinence secondary to neurogenic detrusor overactivity. Spinal Cord 2016;54:46-50.   DOI
11 Samal V, Mecl J, Sram J. Submucosal administration of onabotulinumtoxinA in the treatment of neurogenic detrusor overactivity: pilot single-centre experience and comparison with standard injection into the detrusor. Urol Int 2013;91:423-8.   DOI
12 Game X, Castel-Lacanal E, Bentaleb Y, Thiry-Escudie I, De Boissezon X, Malavaud B, et al. Botulinum toxin A detrusor injections in patients with neurogenic detrusor overactivity significantly decrease the incidence of symptomatic urinary tract infections. Eur Urol 2008;53:613-8.   DOI
13 Klaphajone J, Kitisomprayoonkul W, Sriplakit S. Botulinum toxin type A injections for treating neurogenic detrusor overactivity combined with low-compliance bladder in patients with spinal cord lesions. Arch Phys Med Rehabil 2005;86:2114-8.   DOI
14 Abdel-Meguid TA. Botulinum toxin-A injections into neurogenic overactive bladder--to include or exclude the trigone? A prospective, randomized, controlled trial. J Urol 2010;184:2423-8.   DOI
15 Herschorn S, Gajewski J, Ethans K, Corcos J, Carlson K, Bailly G, et al. Efficacy of botulinum toxin A injection for neurogenic detrusor overactivity and urinary incontinence: a randomized, double-blind trial. J Urol 2011;185:2229-35.   DOI
16 Nuanthaisong U, Abraham N, Goldman HB. Incidence of adverse events after high doses of onabotulinumtoxinA for multiple indications. Urology 2014;84:1044-8.   DOI
17 Schurch B, de Seze M, Denys P, Chartier-Kastler E, Haab F, Everaert K, et al. Botulinum toxin type a is a safe and effective treatment for neurogenic urinary incontinence: results of a single treatment, randomized, placebo controlled 6-month study. J Urol 2005;174:196-200.   DOI
18 Zakin E, Simpson D. Evidence on botulinum toxin in selected disorders. Toxicon 2018;147:134-40.   DOI
19 Smith CP, Boone TB, de Groat WC, Chancellor MB, Somogyi GT. Effect of stimulation intensity and botulinum toxin isoform on rat bladder strip contractions. Brain Res Bull 2003;61:165-71.   DOI
20 Khera M, Somogyi GT, Kiss S, Boone TB, Smith CP. Botulinum toxin A inhibits ATP release from bladder urothelium after chronic spinal cord injury. Neurochem Int 2004;45:987-93.   DOI
21 Do TP, Hvedstrup J, Schytz HW. Botulinum toxin: A review of the mode of action in migraine. Acta Neurol Scand 2018;137:442-51.
22 Fergany LA, Shaker H, Arafa M, Elbadry MS. Does sacral pulsed electromagnetic field therapy have a better effect than transcutaneous electrical nerve stimulation in patients with neurogenic overactive bladder? Arab J Urol 2017;15:148-52.   DOI
23 Hu HZ, Granger N, Jeffery ND. Pathophysiology, clinical importance, and management of neurogenic lower urinary tract dysfunction caused by suprasacral spinal cord injury. J Vet Intern Med 2016;30:1575-88.   DOI
24 Schops TF, Schneider MP, Steffen F, Ineichen BV, Mehnert U, Kessler TM. Neurogenic lower urinary tract dysfunction (NLUTD) in patients with spinal cord injury: long-term urodynamic findings. BJU Int 2015;115 Suppl 6:33-8.   DOI
25 Andy UU, Harvie HS, Smith AL, Propert KJ, Bogner HR, Arya LA. Validation of a self-administered instrument to measure adherence to anticholinergic drugs in women with overactive bladder. Neurourol Urodyn 2015;34:424-8.   DOI
26 Krhut J, Samal V, Nemec D, Zvara P. Intradetrusor versus suburothelial onabotulinumtoxinA injections for neurogenic detrusor overactivity: a pilot study. Spinal Cord 2012;50:904-7.   DOI
27 Apostolidis A, Thompson C, Yan X, Mourad S. An exploratory, placebo-controlled, dose-response study of the efficacy and safety of onabotulinumtoxinA in spinal cord injury patients with urinary incontinence due to neurogenic detrusor overactivity. World J Urol 2013;31:1469-74.   DOI
28 Sussman D, Patel V, Del Popolo G, Lam W, Globe D, Pommerville P. Treatment satisfaction and improvement in health-related quality of life with onabotulinumtoxinA in patients with urinary incontinence due to neurogenic detrusor overactivity. Neurourol Urodyn 2013;32:242-9.   DOI
29 Cruz F, Herschorn S, Aliotta P, Brin M, Thompson C, Lam W, et al. Efficacy and safety of onabotulinumtoxinA in patients with urinary incontinence due to neurogenic detrusor overactivity: a randomised, double-blind, placebo-controlled trial. Eur Urol 2011;60:742-50.   DOI
30 Chen YC, Kuo HC. The therapeutic effects of repeated detrusor injections between 200 or 300 units of onabotulinumtoxinA in chronic spinal cord injured patients. Neurourol Urodyn 2014;33:129-34.   DOI
31 Chen CY, Liao CH, Kuo HC. Therapeutic effects of detrusor botulinum toxin A injection on neurogenic detrusor overactivity in patients with different levels of spinal cord injury and types of detrusor sphincter dyssynergia. Spinal Cord 2011;49:659-64.   DOI
32 Schurch B, Denys P, Kozma CM, Reese PR, Slaton T, Barron R. Reliability and validity of the Incontinence Quality of Life questionnaire in patients with neurogenic urinary incontinence. Arch Phys Med Rehabil 2007;88:646-52.   DOI
33 Schurch B, Denys P, Kozma CM, Reese PR, Slaton T, Barron RL. Botulinum toxin A improves the quality of life of patients with neurogenic urinary incontinence. Eur Urol 2007;52:850-8.   DOI