OnabotulinumtoxinA (Botox A) for Neurogenic Detrusor; Evidence for 200 U vs. 300 U

OnabotulinumtoxinA (Botox A) has gone from investigational to a recognized standard for neurogenic detrusor overactivity (NDO) in patients intolerant or inadequately managed by anticholinergics. A large number of initial studies were done using the 300 unit dose, including the initial report on 200...

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Bibliographic Details
Published inCurrent bladder dysfunction reports Vol. 10; no. 4; pp. 315 - 317
Main Author Murray, Brian P.
Format Journal Article
LanguageEnglish
Published New York Springer US 01.12.2015
Subjects
Geriatrics/Gerontology
Gynecology
Medicine
Medicine & Public Health
Neurogenic Bladder (CR Powell
Section Editor
Topical Collection on Neurogenic Bladder
Urology
OnabotulinumtoxinA
Multiple sclerosis
BotoxA
Neurogenic detrusor overactivity
Spinal cord injury
Parkinson’s disease
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Summary:OnabotulinumtoxinA (Botox A) has gone from investigational to a recognized standard for neurogenic detrusor overactivity (NDO) in patients intolerant or inadequately managed by anticholinergics. A large number of initial studies were done using the 300 unit dose, including the initial report on 200 vs. 300 U. There was a suggestion that 300 units may have some advantage but statistical sample size was small. Two pivotal phase 3 studies compare 200 units to 300 units of BotoxA for NDO. The result of these studies did not show an advantage to the higher dose. These studies did lead to the Food and Drug Administration (FDA) approval, in August 2011, of BotoxA 200 units for refractory or inadequately treated NDO patients. A subsequent pooled extension study was performed. Patients were then followed for five to eight treatment cycles of onabotulinumtoxinA. The data demonstrated no significant increased efficacy of the higher dose of onabotulinumtoxinA for patient management.
ISSN:1931-7212
1931-7220
DOI:10.1007/s11884-015-0320-9