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Title: Patient factors associated with onabotulinum toxin A treatment outcome in women with detrusor overactivity
Authors: Owen, Rhiannon K.
Abrams, Keith R.
Mayne, Christopher
Slack, M.
Tincello, Douglas Gordon
First Published: 12-Jan-2016
Citation: Neurourology and Urodynamics, 2016 (Early View - publication before press)
Abstract: OBJECTIVE: To evaluate potential predictors of non-response to treatment with 200U onabotulinum toxin A (onaBoNTA) in women with refractory detrusor overactivity (DO). SUBJECTS AND METHODS: A secondary analysis of a randomized trial of 200U onaBoNTA versus placebo in women with refractory DO analyzed baseline and 6 week follow-up data. Univariate and multivariate logistic regression were used to assess demographic factors and baseline clinical parameters on non-response to treatment defined as 20% or less improvement in urinary urgency and leakage episodes, 10% or less in voiding frequency, not achieving continence, and "no change" or worse on PGI-I score at 6 weeks. RESULTS: One Hundred and twenty-two women were included. Twenty-nine (23.8%), 24 (19.7%), and 19 (15.6%) were non-responders to treatment for urgency, voiding, and leakage episodes, respectively. Fifty-nine (48.4%) failed to achieve continence, and 28 (23%) were non-responders on the PGI-I scale. Smoking status (OR: 2.89 95%CI 1.08, 7.73, P = 0.034) predicted non-response in urgency episodes, and higher baseline leakage episodes (OR: 1.17 95%CI 1.04, 1.31, P = 0.007) predicted non-response in achieving continence. Increasing age (OR 1.04, 95%CI 1.0, 1.09, P = 0.063) and body mass index (BMI) (OR 1.07, 95%CI 1.0, 1.16, P = 0.065) showed marginal associations with non-response on the PGI-I scale. CONCLUSION: onaBoNTA is an effective treatment for refractory DO, but some fail to respond. For identification of women at risk, our data indicate smokers should be advised of a lesser chance of successful treatment. Older women, those with high BMI and with more severe leakage also have a higher risk of failure. Neurourol. Urodynam. © 2016 Wiley Periodicals, Inc.
DOI Link: 10.1002/nau.22948
ISSN: 0733-2467
eISSN: 1520-6777
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2016 Wiley Periodicals, Inc. This is the peer reviewed version of the following article: Owen, R. K., Abrams, K. R., Mayne, C., Slack, M. and Tincello, D. G. (2016), Patient factors associated with onabotulinum toxin A treatment outcome in women with detrusor overactivity. Neurourol. Urodyn.., which has been published in final form at This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Description: The file associated with this record is under a 12-month embargo from publication in accordance with the publisher's self-archiving policy. The full text may be available through the publisher links provided above.
Appears in Collections:Published Articles, Dept. of Health Sciences

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