Clean intermittent catheterization rates after initial and subsequent treatments with onabotulinumtoxinA for non-neurogenic overactive bladder in real-world clinical settings
| Autor: | Scott MacDiarmid, Lonny Green, Nancy Alvandi, Brian Murray, Salim Wehbe, Marc Schwartz, John Joseph Smith, Jeffrey Mangel, Tamer Aboushwareb, Michael Kennelly |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Intermittent Urethral Catheterization
Male medicine.medical_specialty 030232 urology & nephrology Urology Cholinergic Antagonists law.invention Injections 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Outcome Assessment Health Care medicine Humans Botulinum Toxins Type A Aged Retrospective Studies 030219 obstetrics & reproductive medicine Urinary bladder Urinary retention business.industry Urinary Bladder Overactive Incidence (epidemiology) Incidence Retrospective cohort study General Medicine Clean Intermittent Catheterization Middle Aged Urinary Retention medicine.disease United States medicine.anatomical_structure Logistic Models Overactive bladder Female medicine.symptom business |
| Zdroj: | Current medical research and opinion. 34(10) |
| ISSN: | 1473-4877 |
| Popis: | Previous randomized controlled trials have reported a 6.1-6.9% incidence of clean intermittent catheterization (CIC) following treatment with onabotulinumtoxinA in non-neurogenic overactive bladder (OAB) patients who were inadequately managed by ≥1 anticholinergic. A multi-center retrospective chart review assessed the real-world rate of voiding dysfunction requiring catheterization.Patients received onabotulinumtoxinA 100 U (approved dose) administered by experienced injectors between January 2013 and June 2015. Patients using CIC or an indwelling catheter for ≥24 hours for voiding dysfunction prior to onabotulinumtoxinA injections were excluded. The primary outcome was post-treatment CIC (lasting24 hours; per individual physician's clinical judgment considering patient's voiding symptoms, post-void residual [PVR] urine volumes and patient bother). Potential baseline predictors of CIC (history of pelvic prolapse, cystocele, diabetes, PVR urine volume and age) were assessed using multivariable logistic regression.Overall, 299 patients received their first treatment with onabotulinumtoxinA 100 U. Mean age was 66.4 years; 98.3% were female. The incidence of CIC was 2.7% in the total study population after the first treatment with onabotulinumtoxinA. The de novo CIC rate in treatments 2 and 3 combined was similarly low (3.2%). None of the evaluated baseline characteristics were significant predictors of CIC initiation due to the low CIC incidence.This real-world study of non-neurogenic OAB patients treated with onabotulinumtoxinA suggests that the CIC rate is lower than the rates reported in previous studies. There were no significant correlations between baseline predictors and CIC initiation, although statistical significance may not have been reached because of the low incidence of CIC. |
| Databáze: | OpenAIRE |
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