Results of a BoNT/A antibody study in children and adolescents after onabotulinumtoxin A (Botox®) detrusor injection
| Autor: | Helmut H. Knispel, H Bigalke, J Herholz, Heinrich Schulte-Baukloh, Kurt Miller |
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| Rok vydání: | 2011 |
| Předmět: |
Detrusor muscle
Male medicine.medical_specialty Adolescent Urology Urinary system Risk Assessment Young Adult Risk Factors Germany medicine Humans Prospective Studies Treatment Failure Young adult Botulinum Toxins Type A Prospective cohort study Child Urinary bladder Chi-Square Distribution business.industry Urinary Bladder Overactive Incidence (epidemiology) Botulinum toxin Antibodies Bacterial Surgery Urodynamics medicine.anatomical_structure Administration Intravesical Neuromuscular Agents Female business Chi-squared distribution Biomarkers medicine.drug |
| Zdroj: | Urologia internationalis. 87(4) |
| ISSN: | 1423-0399 |
| Popis: | Background: Onabotulinumtoxin A (OnaBoNT/A, Botox®) is effective in the treatment of neurogenic detrusor overactivity, however this therapy can fail. In a prospective study, we analyzed patient serum for BoNT/A antibodies (BoNT/A-AB) as a possible cause of therapy failure. Methods: 17 patients (average age 14.5 years) who had neurogenic detrusor overactivity were admitted for repeated OnaBoNT/A injection into the detrusor muscle. We analyzed their serum for BoNT/A-AB. The clinical findings were correlated with the incidence of BoNT/A-AB. Results: Positive BoNT/A-AB were clearly or marginally determined in 6 patients. Therapy had failed in all 6. In 4 of the 6, therapy might have failed because of a low-compliance bladder (3 patients) or tethered-cord syndrome (1), but BoNT/A-AB were found as the only possible cause in 2 patients. Thus, the incidence of BoNT/A-AB in the 17 patients was 35%, and the antibodies were clinically significant in 12%. All patients with BoNT/A-AB had a history of recurrent urinary tract infections. Conclusions: Patients who show a failure of therapy after OnaBoNT/A injections for which no other causes can be determined should have their serum checked for BoNT/A-AB. Recurrent urinary tract infection might be a predisposing factor for BoNT/A-AB. |
| Databáze: | OpenAIRE |
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