Cohen Brian L, Caruso Daniel J, Kanagarajah Prashanth, Gousse Angelo E
Department of Urology, University of Miami Miller School of Medicine, Miami, FL 33101, USA.
Adv Urol. 2009;2009:328364. doi: 10.1155/2009/328364. Epub 2009 Sep 8.
To evaluate whether there are any demographic or urodynamic differences in patients with idiopathic overactive bladder (I-OAB) that respond and do not respond to intradetrusor injections of botulinum toxin-A (BTX-A).
This represents a secondary analysis of data collected from an investigator initiated randomized trial designed to evaluate clinical differences in outcomes for 100 versus 150 U BTX-A in patients with I-OAB. Preinjection demographic and urodynamic data were collected. Patients were evaluated 12 weeks after injection and were determined to be responders or nonresponders as defined by our criteria. Statistical comparisons were made between groups.
In patients with overactive bladder without incontinence (OAB-Dry), there were no variables that could be used to predict response to BTX-A. On univariate analysis, younger patients with overactive bladder with incontinence (OAB-Wet) were more likely to respond to BTX-A than older patients. However, this relationship was no longer statistically significant on multivariate analysis.
We were unable to identify any preinjection demographic or urodynamic parameters that could aid in predicting which patients will achieve clinical response to BTX-A. Future studies are necessary to further evaluate this question.
评估特发性膀胱过度活动症（I-OAB）患者中，对膀胱逼尿肌注射A型肉毒毒素（BTX-A）有反应和无反应的患者在人口统计学或尿动力学方面是否存在差异。
这是一项对数据的二次分析，数据来自一项由研究者发起的随机试验，该试验旨在评估I-OAB患者接受100单位与150单位BTX-A治疗后临床结局的差异。收集注射前的人口统计学和尿动力学数据。在注射12周后对患者进行评估，并根据我们的标准确定为有反应者或无反应者。对两组进行统计学比较。
在无尿失禁的膀胱过度活动症（OAB-Dry）患者中，没有可用于预测对BTX-A反应的变量。单因素分析显示，有尿失禁的膀胱过度活动症（OAB-Wet）年轻患者比老年患者更可能对BTX-A有反应。然而，多因素分析时这种关系不再具有统计学意义。
我们无法识别任何注射前的人口统计学或尿动力学参数来帮助预测哪些患者会对BTX-A产生临床反应。未来有必要进行进一步研究以评估这个问题。
