Botulinum toxin reduces incontinence in neurogenic OAB patients, European data show

Botulinum toxin type A (Botox) produces a rapid and sustained reduction in the number of daily incontinence episodes and markedly improves patients' quality of life, according to a European phase II clinical trial presented at the AUA annual meeting.

The double-blind, randomized, placebo-controlled, parallel-group study followed 59 patients with neurogenic OAB and incontinence secondary to spinal cord injury (53 patients) or multiple sclerosis (six patients) for a 26-week period at eight treatment centers in Belgium, France, and Switzerland. Patients were randomized in a 1:1:1 ratio to a single treatment of either botulinum toxin, 200 U, botulinum toxin, 300 U, or placebo.

Investigators found that within 2 weeks, daily episodes of urinary incontinence reduced compared with baseline in both botulinum toxin treatment groups. The reduction also was sustained in these groups. The placebo group did not experience a difference.

Also found were significant increases in mean maximum cystometric capacity values and significant decreases in maximum detrusor pressure during bladder contraction values, reported lead investigator Brigitte Schurch, MD, of the University Hospital Balgrist in Zurich, Switzerland.

Using the Incontinence Quality of Life Questionnaire, the patients treated with botulinum toxin showed marked improvement. Increases in total I-QoL scores ranged from 18 to 28.3 (a 38% to 60% increase from baseline) in the 200-U group and 24.6 and 32.7 (a 58% to 77% increase from baseline) in the 300-U group.