Botulinum toxin type A injection for refractory interstitial cystitis: A randomized comparative study and predictors of treatment response. (2nd June 2015)

• Record Type: Journal Article
• Authors: Akiyama, Yoshiyuki; Nomiya, Akira; Niimi, Aya; Yamada, Yukio; Fujimura, Tetsuya; Nakagawa, Tohru; Fukuhara, Hiroshi; Kume, Haruki; Igawa, Yasuhiko; Homma, Yukio
• Is Part Of: International journal of urology. Volume 22:Number 9(2015)
• Page Start: 835
• Page End: 841
• Publication Date: 2015-06-02
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/iju.12833
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main" id="iju12833-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju12833-sec-0001" sec-type="section"> <title>Objectives</title> <p>To determine whether botulinum toxin type A can represent an alternative treatment option for patients with interstitial cystitis refractory to conventional therapies.</p> </sec> <sec id="iju12833-sec-0002" sec-type="section"> <title>Methods</title> <p>This is a single‐center, prospective, open labeled, randomized comparative study. Patients with refractory interstitial cystitis were randomly divided into two groups: immediate injection (group A) or 1‐month delayed injection (group B) of botulinum toxin type A after allocation. The rate of treatment response (global response assessment ≥+1: slightly improved), and changes in symptom scores and frequency volume chart variables were compared between groups 1 month after allocation. Using subjects of both groups as a single cohort, predictive factors for treatment response at 1 month post‐injection and the duration of response were explored.</p> </sec> <sec id="iju12833-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 34 patients (group A <italic>n </italic>= 18, group B <italic>n</italic> = 16) were allocated. The response rate was significantly higher in group A than group B (72.2% <italic>vs</italic> 25.0%, <italic>P</italic> = 0.01). All symptom measures showed significant improvement in group A than group B. When both groups were combined as a single cohort, the response rate was 73.5% at 1 month, 58.8% at 3 months, 38.2% at 6 months and 20.6% at 12 months. The mean duration of response was 5.4 months. Multivariate analysis showed that past exposure to hydrodistension more than three times correlated with better outcomes.</p> </sec> <sec id="iju12833-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Botulinum toxin type A injection could be an alternative treatment option for patients with interstitial cystitis refractory to conventional therapies, especially for those who have received repeated hydrodistensions and transurethral fulguration.</p> </sec> </abstract>