The use of oxybutynin in patients treated by means of botulinum neurotoxin A for neurogenic detrusor overactivity: An observational study - Abstract

Study design: This is an observational prospective noncontrolled study.

We enrolled 105 patients affected by neurogenic detrusor overactivity (NDO) who underwent botulinum neurotoxin A (BONT-A) intradetrusor injection and were followed-up for 270 days.

Objectives: To investigate the use of oxybutynin after BONT-A administration in NDO patients.

Setting: Careggi University Hospital in Florence and Tor Vergata University Hospital in Rome.

Methods: Prospective data from two Italian centers were collected in 1 year. Patients showing limited efficacy but good tolerability and adherence to oxybutynin 5 mg three times a day (t.i.d.). were enrolled in the study. Patients received BONT-A intradetrusor injection (onabotulinumtoxinA, 300 U) with a trigone-sparing technique, and the use of oxybutynin was registered at every visit.

Results: 105 patients were included. At visit 1, only 30 patients (28.6%) used oxybutynin t.i.d., whereas 47 (45,2%) used a lower dosage and 28 (26.7%) stopped the therapy. At visit 2, 77.3% of patients who had reduced oxybutynin intake, maintained the dosage decided at visit 1. At visit 3, 51.9% returned to oxybutynin t.i.d.; 44.8% were on a reduced dosage and only 3 (2.9%) were not taking the drug. At visit 4, only 37.5% of patients were taking less than oxybutynin t.i.d.

Conclusion: This study provides some important insights on the use of oral antimuscarinics in patients treated by means of BONT-A intradetrusor administration for NDO; in particular, it suggests that, after an initial reduction in the use of oxybutynin, patients tend to increase the dosage of this drug during the follow-up after the BONT-A treatment.

Written by:
Finazzi-Agrò E, Topazio L, Perugia C, Lombardi G, Finita Celso M, De Nunzio C, Del Popolo G.   Are you the author?
Unit of Functional Urology, Policlinico Tor Vergata, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.

Reference: Spinal Cord. 2013 May 21. Epub ahead of print.
doi: 10.1038/sc.2013.42

PubMed Abstract
PMID: 23689390 Overactive Bladder (OAB) Section