CHICAGO, IL USA (UroToday) - In this double-blinded study of 249 participants, 242 were available for analysis.
Both groups, (anticholinergic versus Botox®) were demographically similar. Each patient kept a three-day diary for six months. Overall both treatments demonstrated significant improvements in quality of life (daily urgency, UI, and symptom-specific QoL).
The drug-naïve patients had only one 100u intradetrusor injection of Botox. In the anticholinergic group, the 6-month dosing allowed dose escalation from 5mg solifenacin to 10mg to 60mg trospium as needed. Both groups had sustained improvement throughout the 6-month period. One difference, the Botox group had 27% complete resolution versus the anticholinergic group with 13% complete resolution. As for adverse events, there was no difference in dry eye or constipation rates between the two groups; however, the UTI rate was higher in Botox group (33% versus 16% respectively). A cost effective analysis was not part of this study. All Botox procedures were done in an office setting with local anesthesia to the bladder and no serious adverse events were reported. Upon questioning, how did the group assure compliance to take the anticholinergic pills during the study period? Pill counts and mcaps were used to identify how many times the pill box was opened and whether participants actually take the medication.
Secondary analysis is planned to look at patient compliance. While the Botox group demonstrated a 2-fold higher likelihood to achieve complete urgency urinary continence with less dry mouth, this group had higher transient urinary retention and UTI compared to the anticholinergics group.
Presented by A.G. Visco* at the annual American Urogynecologic Society (AUGS) 33rd Annual Scientific Meeting - October 3 - 6, 2012 - Hilton Chicago - Chicago, Illinois USA
* Duke University, Durham, NC USA
Reported for UroToday by Karen Roberts, Medical Editor
This year’s 33rd Annual Meeting of the American Urogynecologic Society (AUGS) is the largest gathering to date with an increase in abstracts (346) and video presentations (41). AUGS reports an overall membership increase at 1,500 members.
