Despite reported symptomatic improvement, a significant proportion of patients who receive intra-detrusor onabotulinumtoxinA (onabotA [Botox]) for overactive bladder may not follow up for repeat injections, according to new data presented at the AUA annual meeting in San Francisco.
Studies have shown that onabotA injections are highly efficacious for treating overactive bladder (OAB). However, it appears that many patients who have a good response to initial injections and subjective improvement fail to return for subsequent injections, according to a new retrospective study.
“At our institution, 86% of patients had subjective improvement after the first injection. However, only 54% of those patients with improvement went on to receive a second injection. In addition, only 24% with no improvement went to receive a second injection,” said study investigator Justina Tam, MD, Stony Brook Medicine, Stony Brook, NY, working with Jason Kim, MD, and colleagues.
Dr. Tam and her colleagues examined the outcomes of onabotA injections at their own institution and evaluated factors that appear to correlate with continuation of maintenance onabotA injection. They conducted a retrospective chart review on all patients who received onabotA injections from April 2013 to October 2017. For this investigation, the authors compared patients who received one injection to those patients who received more than one injection.
The team identified 175 patients who received at least one onabotA injection. They found that 150 patients (86%) reported subjective symptom improvement after their first injection. Of those who reported improvement, only 81 patients (54%) returned for a second injection. Among those patients who reported no improvement, six patients (24%) also received a second injection. Dr. Tam said in total 87 patients (50%) returned for a second injection.