Charles Joussain1, Mélanie Popoff2, Véronique Phé3, Alexia Even2, Pierre-Olivier Bosset4, Sandra Pottier5, Laetitia Falcou2, Jonathan Levy2, Isabelle Vaugier5, Emmanuel Chartier Kastler3, Brigitte Schurch6, Pierre Denys1,2. 1. Medical School Paris Île-de-France Ouest, Inserm U1179, Versailles Saint-Quentin University, Versailles, France. 2. Department of Physical Medicine and Rehabilitation, Hôpital Raymond-Poincaré AP-HP, Garches, France. 3. Department of Urology, Pitié-Salpêtrière Academic Hospital, Assistance Publique-Hôpitaux de Paris, Pierre and Marie Curie Medical School, Paris, France. 4. Department of Urology, Hôpital Foch, Suresnes, France. 5. CIC IT Hopital Raymond Poincaré, Garches, France. 6. Department of Clinical Neuroscience, Neuropsychology and Neurorehabilitation Service, Lausanne University Hospital, Lausanne, Switzerland.
Abstract
AIMS: Aims of this study were to assess the long-term outcomes of Intradetrusor injection of OnabotulinumtoxinA (Botox® injection) associated with clean intermittent-catheterization (CIC) for the treatment of neurogenic detrusor overactivity (NDO) and to identify risk factors for failure. METHODS: Neurological patients with NDO using CIC who had received Botox® injections between January 2001 and September 2013 were included. Clinical, urodynamic and radiological data were recorded. Primary endpoint was failure and withdrawal rates after 3, 5, and 7 years of management. Survival curves of withdrawals and failures of treatment were calculated with a 95-confidence interval using the Kaplan-Meier method. Risk factors for failure were determined with univariate analysis and multivariate analysis using Cox model. RESULTS: Overall, 292 patients, mean age of 40 ± 13, 6 years, were included. Overall, 219 patients (80.6%; IC95% [76.3-85.4%]) were still treated with Botox® injections after 3 years, 128 (71.1%; IC95% [65.7%, 76.9%]) after 5 years, and 58 (60.8%, IC95% [54.0%, 68.4%]) after 7 years. Failure rate was 12.6% (IC95% [8.6-16.5%]) after 3 years, 22.2% (IC95% [16.6-27.3%]) after 5 years, and 28.9% (IC95% [21.9%; 35.3%]) after 7 years of follow-up. Withdrawal rate after 7 years of follow-up was 11.3% (n = 33/292). Severe NDO at baseline appears to be a significant risk factor for failure. CONCLUSION: This study confirms long-term efficacy and tolerance of Botox® injection in patients with NDO using CIC. Long-term failure and withdrawal rates remain low but significant, and need to be managed.
AIMS: Aims of this study were to assess the long-term outcomes of Intradetrusor injection of OnabotulinumtoxinA (Botox® injection) associated with clean intermittent-catheterization (CIC) for the treatment of neurogenic detrusor overactivity (NDO) and to identify risk factors for failure. METHODS: Neurological patients with NDO using CIC who had received Botox® injections between January 2001 and September 2013 were included. Clinical, urodynamic and radiological data were recorded. Primary endpoint was failure and withdrawal rates after 3, 5, and 7 years of management. Survival curves of withdrawals and failures of treatment were calculated with a 95-confidence interval using the Kaplan-Meier method. Risk factors for failure were determined with univariate analysis and multivariate analysis using Cox model. RESULTS: Overall, 292 patients, mean age of 40 ± 13, 6 years, were included. Overall, 219 patients (80.6%; IC95% [76.3-85.4%]) were still treated with Botox® injections after 3 years, 128 (71.1%; IC95% [65.7%, 76.9%]) after 5 years, and 58 (60.8%, IC95% [54.0%, 68.4%]) after 7 years. Failure rate was 12.6% (IC95% [8.6-16.5%]) after 3 years, 22.2% (IC95% [16.6-27.3%]) after 5 years, and 28.9% (IC95% [21.9%; 35.3%]) after 7 years of follow-up. Withdrawal rate after 7 years of follow-up was 11.3% (n = 33/292). Severe NDO at baseline appears to be a significant risk factor for failure. CONCLUSION: This study confirms long-term efficacy and tolerance of Botox® injection in patients with NDO using CIC. Long-term failure and withdrawal rates remain low but significant, and need to be managed.
Authors: O Blé; J Levy; C Lefèvre; M A Perrouin-Verbe; A Even; L Le Normand; E Chartier Kastler; B Perrouin-Verbe; P Denys; C Joussain Journal: World J Urol Date: 2022-06-01 Impact factor: 4.226
Authors: Charles Joussain; Olivier Le Coz; Andrey Pichugin; Peggy Marconi; Filip Lim; Mariaconcetta Sicurella; Andrea Salonia; Francesco Montorsi; Francisco Wandosell; Keith Foster; François Giuliano; Alberto L Epstein; Alejandro Aranda Muñoz Journal: Toxins (Basel) Date: 2019-02-19 Impact factor: 4.546
Authors: Jacquie Maignel; Vincent Martin; Rana Assaly; Mathieu L Vogt; Kevin Retailleau; Fraser Hornby; Alexandra Laugerotte; Stéphane Lezmi; Pierre Denys; Johannes Krupp; Charles Joussain Journal: Toxins (Basel) Date: 2022-01-21 Impact factor: 4.546