A Korean Postmarketing Study Assessing the Effectiveness of OnabotulinumtoxinA for the Treatment of Neurogenic Detrusor Overactivity or Idiopathic Overactive Bladder Using a Validated Patient-Reported Outcome Measure
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Purpose: OnabotulinumtoxinA has demonstrated efficacy and safety in the treatment of urinary incontinence (UI) associated with neurogenic detrusor overactivity (NDO) and idiopathic overactive bladder (OAB); however, real-world evidence is limited. This postmarketing surveillance study aimed to assess the effectiveness and safety of onabotulinumtoxinA in Korean patients with UI associated with NDO or OAB with an inadequate response or intolerance to anticholinergics. Methods: Patients received 200 U (NDO) or 100 U (OAB) of onabotulinumtoxinA. Effectiveness (assessed using the validated International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF]) and safety were assessed for 1–4 months after onabotulinumtoxinA administration. Results: Overall, 686 patients (NDO, 161; OAB, 525) comprised the safety population; of these, 612 patients were analyzed for effectiveness. There was a significant decrease (P<0.0001) in the mean (standard deviation) ICIQ-SF scores in the NDO (–6.8±5.5) and OAB (–6.0±6.4) groups after onabotulinumtoxinA administration. A decrease of >5 points from baseline in the ICIQ-SF score was observed in 64.9% and 47.3% of patients in the NDO and OAB groups, respectively. Following treatment, 59.9% in the NDO group and 43.0% in the OAB group were dry. There was no effect of age on effectiveness in either group. Only 10 adverse drug reactions (ADRs) were reported in 5.6% of NDO patients and 20 ADRs in 3.2% of OAB patients. Most ADRs in both groups were related to the lower urinary tract such as dysuria (NDO, 1.2%; OAB, 0.6%) and urinary retention (NDO, 0.6%; OAB, 1.5%). Conclusions: Effectiveness and safety of onabotulinumtoxinA in Korea in a real-world setting was demonstrated.
Abstract
Purpose: OnabotulinumtoxinA has demonstrated efficacy and safety in the treatment of urinary incontinence (UI) associated with neurogenic detrusor overactivity (NDO) and idiopathic overactive bladder (OAB); however, real-world evidence is limited. This postmarketing surveillance study aimed to assess the effectiveness and safety of onabotulinumtoxinA in Korean patients with UI associated with NDO or OAB with an inadequate response or intolerance to anticholinergics. Methods: Patients received 200 U (NDO) or 100 U (OAB) of onabotulinumtoxinA. Effectiveness (assessed using the validated International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF]) and safety were assessed for 1–4 months after onabotulinumtoxinA administration. Results: Overall, 686 patients (NDO, 161; OAB, 525) comprised the safety population; of these, 612 patients were analyzed for effectiveness. There was a significant decrease (P<0.0001) in the mean (standard deviation) ICIQ-SF scores in the NDO (–6.8±5.5) and OAB (–6.0±6.4) groups after onabotulinumtoxinA administration. A decrease of >5 points from baseline in the ICIQ-SF score was observed in 64.9% and 47.3% of patients in the NDO and OAB groups, respectively. Following treatment, 59.9% in the NDO group and 43.0% in the OAB group were dry. There was no effect of age on effectiveness in either group. Only 10 adverse drug reactions (ADRs) were reported in 5.6% of NDO patients and 20 ADRs in 3.2% of OAB patients. Most ADRs in both groups were related to the lower urinary tract such as dysuria (NDO, 1.2%; OAB, 0.6%) and urinary retention (NDO, 0.6%; OAB, 1.5%). Conclusions: Effectiveness and safety of onabotulinumtoxinA in Korea in a real-world setting was demonstrated.
참고문헌 (29)
- Irwin DE, "Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries : results of the EPIC study", Eur Urol, 50, pp.1306~1314 (2006)
- Lee YS, "Prevalence of overactive bladder, urinary incontinence, and lower urinary tract symptoms : results of Korean EPIC study", World J Urol, 29, pp.185~190 (2011)
- Hicken BL, "Bladder management and quality of life after spinal cord injury", Am J Phys Med Rehabil, 80, pp.916~922 (2001)
- Phé V, "Management of neurogenic bladder in patients with multiple sclerosis", Nat Rev Urol, 13, pp.275~288 (2016)
- Ruffion A, "Systematic review of the epidemiology of urinary incontinence and detrusor overactivity among patients with neurogenic overactive bladder", Neuroepidemiology, 41, pp.146~155 (2013)
- Lawrenson R, "Renal failure in patients with neurogenic lower urinary tract dysfunction", Neuroepidemiology, 20, pp.138~143 (2001)
- Abrams P, "The standardisation of terminology of lower urinary tract function : report from the Standardisation Sub-committee of the International Continence Society", Am J Obstet Gynecol, 187, pp.116~126 (2002)
- Stewart WF, "Prevalence and burden of overactive bladder in the United States", World J Urol, 20, pp.327~336 (2003)
- Tang DH, "Impact of urinary incontinence on healthcare resource utilization, health-related quality of life and productivity in patients with overactive bladder", BJU Int, 113, pp.484~491 (2014)
- Chapple CR, "The effects of antimuscarinic treatments in overactive bladder : an update of a systematic review and meta-analysis", Eur Urol, 54, pp.543~562 (2008)
- Madhuvrata P, "Anticholinergic drugs for adult neurogenic detrusor overactivity : a systematic review and meta-analysis", Eur Urol, 62, pp.816~830 (2012)
- Brostrøm S, "Persistence of antimuscarinic drug use", Eur J Clin Pharmacol, 65, pp.309~314 (2009)
- Jundt K, "Anticholinergic therapy : do the patients take the pills prescribed?", Arch Gynecol Obstet, 284, pp.663~666 (2011)
- Sexton CC, "Persistence and adherence in the treatment of overactive bladder syndrome with anticholinergic therapy : a systematic review of the literature", Int J Clin Pract, 65, pp.567~585 (2011)
- Gray SL, "Anticholinergic medication use and dementia : latest evidence and clinical implications", Ther Adv Drug Saf, 7, pp.217~224 (2016)
- "BOTOX® (onabotulinumtoxinA) Prescribing Information" (2019)[URL]
- Cruz F, "Efficacy and safety of onabotulinumtoxinA in patients with urinary incontinence due to neurogenic detrusor overactivity : a randomised, double-blind, placebo-controlled trial", Eur Urol, 60, pp.742~750 (2011)
- Ginsberg D, "Phase 3 efficacy and tolerability study of onabotulinumtoxinA for urinary incontinence from neurogenic detrusor overactivity", J Urol, 187, pp.2131~2139 (2012)
- Nitti VW, "OnabotulinumtoxinA for the treatment of patients with overactive bladder and urinary incontinence : results of a phase 3, randomized, placebo controlled trial", J Urol, 189, pp.2186~2193 (2013)
- Chapple C, "OnabotulinumtoxinA 100 U significantly improves all idiopathic overactive bladder symptoms and quality of life in patients with overactive bladder and urinary incontinence : a randomised, double-blind, placebo-controlled trial", Eur Urol, 64, pp.249~256 (2013)
- 조영삼, "Botulinum toxin in spinal cord injury patients with neurogenic detrusor overactivity", Journal of exercise rehabilitation, 12(6), pp.624~631 (2016), 한국운동재활학회
- Avery K, "ICIQ : a brief and robust measure for evaluating the symptoms and impact of urinary incontinence", Neurourol Urodyn, 23, pp.322~330 (2004)
- "Standard for Re-examination of New Drugs" (2015)[URL]
- Seckiner I, "Correlations between the ICIQ-SF score and urodynamic findings", Neurourol Urodyn, 26, pp.492~494 (2007)
- Klovning A, "Comparison of two questionnaires for assessing the severity of urinary incontinence : The ICIQ-UI SF versus the incontinence severity index", Neurourol Urodyn, 28, pp.411~415 (2009)
- Nyström E, "ICIQ symptom and quality of life instruments measure clinically relevant improvements in women with stress urinary incontinence", Neurourol Urodyn, 34, pp.747~751 (2015)
- Avallone MA, "Less is more-A pilot study evaluating one to three intradetrusor sites for injection of OnabotulinumtoxinA for neurogenic and idiopathic detrusor overactivity", Neurourol Urodyn, 36, pp.1104~1107 (2017)
- Balzarro M, "OnabotulinumtoxinA detrusor injection improves female sexual function in women with overactive bladder wet syndrome", Eur J Obstet Gynecol Reprod Biol, 225, pp.228~231 (2018)
- Chughtai B, "Randomized, double-blind, placebo controlled pilot study of intradetrusor injections of onabotulinumtoxinA for the treatment of refractory overactive bladder persisting following surgical management of benign prostatic hyperplasia", Can J Urol, 21, pp.7217~7221 (2014)
