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).
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).
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.
Most patients refractory to Botox® (56.14%) draw benefits from the switch to Dysport®.
Neurourology and urodynamics. 2017 Apr 21 [Epub ahead of print]
Florie Bottet, Benoit Peyronnet, Romain Boissier, Bénédicte Reiss, Jean G Previnaire, Andrea Manunta, Jacques Kerdraon, Alain Ruffion, Loïc Lenormand, Brigitte Perrouin Verbe, Sarah Gaillet, Xavier Gamé, Gilles Karsenty, Groupe d'Etude de Neuro-Urologie de Langue Française (GENULF) and the committee of NeuroUrology of the French Association of Urology (AFU)
Department of Urology, Tenon Hospital, Paris, France., Department of Urology, University Hospital of Rennes, Rennes, France., Department of Urology, University Hospital of Marseille, Marseille, France., Department of Physical Medicine and Rehabilitation, University Hospital of Nantes, Nantes, France., Department of Physical Medicine and Rehabilitation, Jacques-Calvé Center, Berck, France., Department of Physical Medicine and Rehabilitation, Kerpape Hospital, Ploemeur, France., Department of Urology, University Hospital of Lyon, Lyon, France., Department of Urology, University Hospital of Nantes, Nantes, France., Department of Urology, University Hospital of Toulouse, Toulouse, France.