Article ; Online: Efficacy of abobotulinumtoxinA versus onabotulinumtoxinA for the treatment of refractory neurogenic detrusor overactivity: a systematic review and indirect treatment comparison.
2023 Volume 26, Issue 1, Page(s) 200–207
Abstract: Aims: To compare the efficacy and safety of abobotulinumtoxinA (aboBoNT-A) and onabotulinumtoxinA (onaBoNT-A) for the treatment of refractory neurogenic detrusor overactivity (NDO), using an indirect treatment comparison (ITC).: Materials and methods!# ...
| Abstract | Aims: To compare the efficacy and safety of abobotulinumtoxinA (aboBoNT-A) and onabotulinumtoxinA (onaBoNT-A) for the treatment of refractory neurogenic detrusor overactivity (NDO), using an indirect treatment comparison (ITC). Materials and methods: A systematic literature review was used to identify randomized controlled trials (RCTs) that evaluated botulinum toxin type A for the treatment of refractory NDO. Treatments were compared using a Bucher ITC approach. Efficacy outcomes were reduction in number of weekly urinary incontinence (UI) episodes at 6, 12, and 24 weeks of follow-up. The safety outcome was the proportion of patients with treatment-emergent urinary tract infections (TE-UTIs) during follow-up. Subgroup/sensitivity analyses were performed to investigate the impact of heterogeneity. Results: Fifteen studies of botulinum toxin type A were identified. Among these, onaBoNT-A 200 U was the only botulinum toxin type A considered an appropriate comparator for aboBoNT-A 600 U and 800 U. As such, six RCTs that evaluated onaBoNT-A or aboBoNT-A were included in the ITC. In base-case analyses, there were no statistically significant differences between aboBoNT-A and onaBoNT-A in terms of UI episodes or TE-UTIs. Numerically, the trend favored aboBoNT-A (either dose) for all endpoints and time points. At 12 and 24 weeks, the difference in reduction of UI episodes per week was considered clinically relevant when comparing aboBoNT-A 800 U with onaBoNT-A 200 U, but not when comparing the lower dose of aboBoNT-A (600 U) with onaBoNT-A 200 U. Results from subgroup/sensitivity analyses were consistent with the base case. Limitations: Heterogeneity across studies was observed; however, strong consistency of trends across analyses suggests the impact of heterogeneity is low. Conclusions: There may be potential advantages of aboBoNT-A over onaBoNT-A, in terms of UI reduction, in patients with refractory NDO. More confirmatory studies are needed owing to the sparsity of current evidence. |
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| MeSH term(s) | Humans ; Botulinum Toxins, Type A/therapeutic use ; Neuromuscular Agents/therapeutic use ; Treatment Outcome ; Urinary Bladder, Neurogenic/drug therapy ; Urinary Bladder, Overactive/drug therapy ; Urinary Incontinence/drug therapy ; Urinary Tract Infections/drug therapy ; Urodynamics |
| Chemical Substances | abobotulinumtoxinA (EC 3.4.24.69) ; Botulinum Toxins, Type A (EC 3.4.24.69) ; Neuromuscular Agents ; onabotulinum toxin A (EC 3.4.24.69) |
| Language | English |
| Publishing date | 2023-01-17 |
| Publishing country | England |
| Document type | Comparative Study ; Journal Article ; Systematic Review |
| ZDB-ID | 2270945-9 |
| ISSN | 1941-837X ; 1369-6998 |
| ISSN (online) | 1941-837X |
| ISSN | 1369-6998 |
| DOI | 10.1080/13696998.2023.2165366 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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