Efficacy and Safety of OnabotulinumtoxinA in Treating Neurogenic Detrusor Overactivity： A Systematic Review and Meta-analysis  

作　　者：Xin Zhou Hui-Lei Yan Yuan-Shan Cui Huan-Tao Zong Yong Zhang 

机构地区：[1]Department of Urology, Beijing Tian Tan Hospital, Capital Medical University Neurourology Research Division, China National Clinical Research Center for Neurological Disease, Beijing 100050, China [2]Graduate School of Capital Medical University, Capital Medical University, Beijing 100069, China [3]Department of Urology, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264000, China

出　　处：《Chinese Medical Journal》2015年第7期963-968,共6页中华医学杂志（英文版）

摘　　要：Background： OnabotulinumtoxinA is widely used in treating neurogenic detrusor overactivity （NDO）. We carried out a systematic review and meta-analysis to assess the efficacy and safety of the drug for treating NDO. Methods： We searched the following databases： Medline, EMBASE, and the Cochrane Controlled Trials Register. All published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for the treatment of NDO were identified in the analysis. The reference lists of the retrieved studies were also investigated. Results： Four publications involving a total of 807 patients were identified in the analysis, which compared onabotulinumtoxinA with placebo. The changes of the mean number of urinary incontinence per week （the standardized mean difference [SMD] = -10.91, 95% confidence intervals [C/s] = -14.18-7.63, P 〈 0.0001）; maximum cystometric capacity （SMD = 146.09, 95% CI = 126.19-165.99, P 〈 0.0001） and maximum detrusor pressure （SMD = -32.65, 95% CI = -37.83--27.48, P 〈 0.0001 ） indicated that onabotulinumtoxinA was more effective than the placebo, despite the doses ofonabotulinumtoxinA. Safety assessments primarily localized to the urinary tract indicated onabotulinumtoxinA were often associated with more complications. Urinary tract infections （relative risk [RR] = 1.48, 95% CI = 1.20- 1.81, P = 0.0002）; hematuria （RR = 1.81, 95% CI = 1.00-3.24, P = 0.05） and urinary retention （RR = 5.87, 95% CI = 3.61-9.56, P 〈 0.0001 ）. Conclusions： This meta-analysis indicates that onabotulinumtoxinA to be an effective treatment for NDO with side effects primarily localized to urinary tract.Background： OnabotulinumtoxinA is widely used in treating neurogenic detrusor overactivity （NDO）. We carried out a systematic review and meta-analysis to assess the efficacy and safety of the drug for treating NDO. Methods： We searched the following databases： Medline, EMBASE, and the Cochrane Controlled Trials Register. All published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for the treatment of NDO were identified in the analysis. The reference lists of the retrieved studies were also investigated. Results： Four publications involving a total of 807 patients were identified in the analysis, which compared onabotulinumtoxinA with placebo. The changes of the mean number of urinary incontinence per week （the standardized mean difference [SMD] = -10.91, 95% confidence intervals [C/s] = -14.18-7.63, P 〈 0.0001）; maximum cystometric capacity （SMD = 146.09, 95% CI = 126.19-165.99, P 〈 0.0001） and maximum detrusor pressure （SMD = -32.65, 95% CI = -37.83--27.48, P 〈 0.0001 ） indicated that onabotulinumtoxinA was more effective than the placebo, despite the doses ofonabotulinumtoxinA. Safety assessments primarily localized to the urinary tract indicated onabotulinumtoxinA were often associated with more complications. Urinary tract infections （relative risk [RR] = 1.48, 95% CI = 1.20- 1.81, P = 0.0002）; hematuria （RR = 1.81, 95% CI = 1.00-3.24, P = 0.05） and urinary retention （RR = 5.87, 95% CI = 3.61-9.56, P 〈 0.0001 ）. Conclusions： This meta-analysis indicates that onabotulinumtoxinA to be an effective treatment for NDO with side effects primarily localized to urinary tract.

关 键 词：META-ANALYSIS Neurogenic Detrusor Overactivity ONABOTULINUMTOXINA Randomized Controlled Trial 

分 类 号：TS201.6[轻工技术与工程—食品科学] S858.28[轻工技术与工程—食品科学与工程]