title: Antibodies after botulinum toxin A injection into musculus detrusor vesicae: incidence and clinical relevance.
abstract: OBJECTIVE
  Botulinum toxin A (BTX-A) injection into the detrusor muscle has changed therapy options for patients with overactive bladder (OAB). However, in some patients, therapy fails or the effects of BTX-A decrease. The aim of this prospective study was to evaluate the incidence of BTX-A antibodies (BTX-A Abs) after injection of BTX-A and its clinical relevance.
  
  
  METHODS
  31 patients (27 women, 4 men) were treated with BTX-A for OAB between January 2009 and August 2010. Eleven patients were treated once, 16 patients were treated twice and 4 patients were treated three times. Blood was collected before and 3 months after the BTX-A injection and BTX-A Abs were determined.
  
  
  RESULTS
  In 5 patients (16%) BTX-A Abs were detectable after the BTX-A injection. The BTX-A Ab titer was clearly positive in 1 patient (3.2%). This patient showed complete failure of BTX-A therapy. In 4 patients (13%) BTX-A Abs were slightly positive after the first BTX-A injection. The second BTX-A injection showed no positive effects in only 1 patient with borderline BTX-A Ab titers; the second BTX-A injection was successful in 2 patients.
  
  
  CONCLUSIONS
  The incidence of BTX-A Abs should be verified in nonresponders. More data are necessary to check the clinical relevance and risk of BTX-A Ab formation, especially in long-term follow-up, to optimize patient selection for this minimally invasive treatment option in OAB.
authors: Department of Urology and Pediatric Urology, University Medical Center Marburg, Marburg, Germany. hegele @ med.uni-marburg.de
authors: Axel
authors: A
authors: Hegele
authors: Carsten
authors: C
authors: Frohme
authors: Zoltan
authors: Z
authors: Varga
authors: Peter
authors: P
authors: Olbert
authors: Julia
authors: J
authors: Kranz
authors: Rainer
authors: R
authors: Hofmann
mesh_terms: D000283:Administration, Intravesical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000907:Antibodies, Bacterial / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage* / Q000276:immunology*; D004334:Drug Administration Schedule; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009465:Neuromuscular Agents / Q000008:administration & dosage* / Q000276:immunology*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers; D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A