Switch to Abobotulinum toxin A may be useful in the treatment of neurogenic detrusor overactivity when intradetrusor injections of Onabotulinum toxin A failed

Abstract

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.

Efficacy and tolerance of botulinum toxin injections after sacral nerve stimulation failure for idiopathic overactive bladder

“…In case of primary or secondary failure, a repeat injection either of the same toxin at the same dosage or at a higher dosage or of the other BoNT‐A was performed as previously described in neurogenic patients 8,9 …”

“…In case of primary or secondary failure, a repeat injection either of the same toxin at the same dosage or at a higher dosage or of the other BoNT-A was performed as previously described in neurogenic patients. 8,9 2.4 | Pre-and posttreatment evaluation Baseline patient characteristics were extracted from medical records. An UDS was performed before SNM test stimulation or before first botulinum toxin injections to detect detrusor overactivity (DO) and eliminate sphincter deficiency.…”

Adolescence transitional care in neurogenic detrusor overactivity and the use of OnabotulinumtoxinA: A clinical algorithm from an Italian consensus statement

“…Currently, aboBNTa treatment has been widely investigated in order to assess its role in case of failure of intradetrusor injections of onaBNTa in the treatment of NDO. 44,45 Studies comparing onaBNTa and aboBNTa in NDO patients are rare. 35 Grosse et al presented a small case control study in 56 patients with variable dosing that could only point out no difference at 9 months between the two formulations.…”

Recommandations jointes des comités de l’AFU (neuro-urologie, CUROPF, CTMH) pour l’urologie fonctionnelle durant la crise sanitaire liée au COVID-19

“…Les patients pour lesquels une entérocystoplastie avec ou sans cystostomie continente était programmée doivent être reprogrammés dans 2 à 4 mois. Groupe C Le traitement alternatif à proposer en cas de traitement par toxine botulique avec échappement consiste en des injections intra-détrusoriennes de toxine botulique A avec escalade de dose ou switch Botox®/Dysport® [16]. En cas de difficulté aux autosondages pendant cette période pourra discutera l'indication de pose d'une sonde à demeure.…”