[Idiopathic overactive bladder and BOTOX(®): Literature review]

Area of Science:

• Urology
• Pharmacology

Background:

• Refractory idiopathic overactive bladder (iOAB) significantly impacts patient quality of life.
• Current treatment options for iOAB may be limited or ineffective for some patients.

Purpose of the Study:

• To systematically review the efficacy and tolerability of onabotulinumtoxinA (BOTOX®) for treating refractory iOAB.
• To evaluate clinical trial data regarding onabotulinumtoxinA's effectiveness and safety in iOAB patients.

Main Methods:

• Systematic literature search of PubMed for clinical trials (Level 1 and 2 evidence) on onabotulinumtoxinA in refractory iOAB.
• Included studies focused on efficacy, toxicity, and adverse events.
• Analysis of data from eleven controlled randomized trials, including three Phase III trials, involving 1008 patients.

Main Results:

• OnabotulinumtoxinA (100 U) demonstrated superior efficacy compared to placebo in improving continence, symptoms, and quality of life in Phase III trials.
• Urodynamic studies showed significant improvements with doses of 100 U or higher.
• Adverse events such as urinary retention and tract infections were manageable and did not negatively affect quality of life.

Conclusions:

• Intradetrusor injections of onabotulinumtoxinA represent a minimally invasive and effective treatment option for refractory iOAB.
• The procedure is well-tolerated, offering significant benefits for patients with refractory idiopathic overactive bladder.