Nottingham Urology Centre, Nottingham University Hospitals, NHS Trust, Nottingham, UK.
BJU Int. 2013 Jul;112(1):94-9. doi: 10.1111/bju.12028. Epub 2013 Mar 12.
To compare the clinical effects of two different commercially available botulinum toxin type A products, onabotulinumtoxinA (Botox(®) ; Allergan Inc., Irvine, CA, USA) and abobotulinumtoxinA (Dysport(®) ; Ipsen Ltd, Slough, UK), on non-neurogenic overactive bladder (OAB).
We included 207 patients, who underwent treatment with botulinum toxin type A for non-neurogenic OAB from January 2009 to June 2012 at our institution, in a prospective database that recorded details of their presentation, treatment and outcomes. In December 2009, our institution switched from using onabotulinumtoxinA to using abobotulinumtoxinA.
Results from the onabotulinumtoxinA cohort (n = 101) and the abobotulinumtoxinA cohort (n = 106) were compared. Similar reductions in daytime frequency, nocturia and incontinence episodes were observed after treatment, with no difference in duration of effect. The abobotulinumtoxinA cohort had almost twice the rate of symptomatic urinary retention (23 vs 42%) requiring intermittent self-catheterisation (ISC).
AbobotulinumtoxinA use was complicated by a significantly higher risk of requiring ISC. The study suggests that these two toxins are not interchangeable at the doses used.
比较两种不同市售的肉毒毒素 A 产品,即注射用肉毒毒素 A(Botox®;Allergan Inc.,美国加利福尼亚州欧文市)和注射用 A 型肉毒毒素(Dysport®;Ipsen Ltd.,英国斯劳),在非神经源性逼尿肌过度活动症(OAB)中的临床疗效。
我们纳入了 207 例 2009 年 1 月至 2012 年 6 月期间在我院因非神经源性 OAB 接受肉毒毒素 A 治疗的患者,这些患者的详细资料记录在我们的前瞻性数据库中,包括他们的临床表现、治疗和结局。2009 年 12 月,我院将使用的肉毒毒素 A 从注射用肉毒毒素 A 切换为注射用 A 型肉毒毒素。
对接受注射用肉毒毒素 A(n=101)和注射用 A 型肉毒毒素(n=106)治疗的患者进行了比较。治疗后,两组患者的日间排尿次数、夜尿和尿失禁发作均有相似程度的减少,作用持续时间无差异。注射用 A 型肉毒毒素组的症状性尿潴留(23%比 42%)发生率更高,需要间歇性自我导尿(ISC)的患者比例几乎是前者的两倍。
注射用 A 型肉毒毒素的使用与更高的 ISC 需求风险相关。该研究表明,这两种毒素在使用剂量上不能互换。