Botulinum Neurotoxin A Intravesical Injections in Interstitial Cystitis/Bladder Painful Syndrome: A Systematic Review with Meta-Analysis.

Abstract

Botulinum neurotoxin A (BoNT/A) appears to be one of the best intravesical treatments for interstitial cystitis/bladder painful syndrome (IC/BPS). We aimed to point out what the evidence is regarding the effects of BoNT/A intravesically injected in patients with IC/BPS. We performed a systematic review of all randomized controlled trials (RCTs) assessing BoNT/A for IC/BPS by using Medline, EMBASE, CINAHL, CENTRAL and MetaRegister of Controlled Trials. Standardized mean differences (SMD) were extracted from the available trials and combined in a meta-analysis applying a random effect model, including heterogeneity of effects. Twelve trials were identified. Significant benefits from BoNT/A injections were detected in: Interstitial Cystitis Symptom Index and Problem Index (ICSI, ICPI) (small to medium effect size: SMD = -0.302; p = 0.007 and -0.430, p = 0.004, respectively); Visual Analog Scale (VAS) for pain and day-time urinary frequency (medium effect size: SMD = -0.576, p < 0.0001 and -0.546, p = 0.013, respectively). A great effect size was detected for post-void residual volume (PVR, SMD = 0.728; p =0.002) although no clinically relevant in most cases. Great heterogeneity was observed in treatments' methodologies and symptoms assessment. Overall, BoNT/A intravesical injections significantly improve some of the most relevant symptoms affecting IC/BPS patients.

• Authors: Antonella Giannantoni, Marilena Gubbiotti, Vittorio Bini
• Journal: Toxins (Toxins (Basel)) Vol. 11 Issue 9 (08 30 2019) ISSN: 2072-6651 [Electronic] Switzerland
• PMID: 31480323 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Botulinum Toxins, Type A

Topics

• Administration, Intravesical
• Animals
• Botulinum Toxins, Type A (therapeutic use)
• Cystitis, Interstitial (drug therapy)
• Humans
• Pain (drug therapy)
• Randomized Controlled Trials as Topic