title: The efficacy and safety of onabotulinumtoxinA in treating idiopathic OAB: A systematic review and meta-analysis.
abstract: OBJECTIVE
  We carried out a systematic review and meta-analysis to assess the efficacy and safety of the drug for treating idiopathic OAB.
  
  
  METHODS
  A literature review was performed to identify all published randomized double-blind, placebo-controlled trials of onabotulinumtoxinA for the treatment of idiopathic OAB. The search included the following databases: MEDLINE, EMBASE, and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated.
  
  
  RESULTS
  Eight publications involving a total of 1,320 patients were used in the analysis, including six RCTs that compared onabotulinumtoxinA with placebo. OnabotulinumtoxinA significantly decreased the mean number of urinary incontinence (UI) per day -2.77 versus -1.01 (the standardized mean difference (SMD) = -1.68, 95% CI = -2.06 to -1.31, P < 0.00001); the mean number of micturitions per day -1.61 versus -0.87 (SMD = -1.82, 95% CI = -2.61 to -1.02, P < 0.00001); maximum cystometric capacity (MCC) 91.39 versus 32.32 (SMD = 63.82, 95% CI = 38.14 to 89.50, P < 0.00001) and volume voided 44.29 versus 7.36 (SMD = 33.05, 95% CI = 22.45 to 43.66, P < 0.00001) versus placebo and 29.20% versus 7.95% of patients became incontinence-free (odds ratio [OR] = 4.89, 95% confidence interval [CI] = 3.11 to 7.70, P < 0.00001). Safety assessments primarily localized to the urinary tract indicated onabotulinumtoxinA were often associated with complications resulting from postvoid residuals (PVR; P < 0.00001), urinary tract infections (UTI; P < 0.00001) and clean intermittent catheterization (CIC; P < 0.00001).
  
  
  CONCLUSIONS
  This meta-analysis indicates that onabotulinumtoxinA to be an effective treatment for idiopathic overactive bladder symptoms with side effects primarily localized to urinary tract.
authors.affiliation: Department of Urology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yuanshan
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Department of Urology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Urology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Huantao
authors.initials: H
authors.lastname: Zong
authors.affiliation: Department of Urology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Huilei
authors.initials: H
authors.lastname: Yan
authors.affiliation: Department of Urology, Beijing Tian-Tan Hospital, Capital Medical University, Beijing, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D065087:Acetylcholine Release Inhibitors / Q000627:therapeutic use*; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D006801:Humans; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D014546:Urinary Catheterization / Q000009:adverse effects; D016055:Urinary Retention / Q000139:chemically induced; D014552:Urinary Tract Infections / Q000139:chemically induced / Q000209:etiology
chemical_list: D065087:Acetylcholine Release Inhibitors; D019274:Botulinum Toxins, Type A
keywords: idiopathic overactive bladder; meta-analysis; onabotulinumtoxinA; randomized controlled trial