title: Patient factors associated with onabotulinum toxin A treatment outcome in women with detrusor overactivity.
abstract: To evaluate potential predictors of non-response to treatment with 200U onabotulinum toxin A (onaBoNTA) in women with refractory detrusor overactivity (DO).
  
  
  
  A secondary analysis of a randomized trial of 200U onaBoNTA versus placebo in women with refractory DO analyzed baseline and 6 week follow-up data. Univariate and multivariate logistic regression were used to assess demographic factors and baseline clinical parameters on non-response to treatment defined as 20% or less improvement in urinary urgency and leakage episodes, 10% or less in voiding frequency, not achieving continence, and "no change" or worse on PGI-I score at 6 weeks.
  
  
  
  One Hundred and twenty-two women were included. Twenty-nine (23.8%), 24 (19.7%), and 19 (15.6%) were non-responders to treatment for urgency, voiding, and leakage episodes, respectively. Fifty-nine (48.4%) failed to achieve continence, and 28 (23%) were non-responders on the PGI-I scale. Smoking status (OR: 2.89 95%CI 1.08, 7.73, P = 0.034) predicted non-response in urgency episodes, and higher baseline leakage episodes (OR: 1.17 95%CI 1.04, 1.31, P = 0.007) predicted non-response in achieving continence. Increasing age (OR 1.04, 95%CI 1.0, 1.09, P = 0.063) and body mass index (BMI) (OR 1.07, 95%CI 1.0, 1.16, P = 0.065) showed marginal associations with non-response on the PGI-I scale.
  
  
  
  onaBoNTA is an effective treatment for refractory DO, but some fail to respond. For identification of women at risk, our data indicate smokers should be advised of a lesser chance of successful treatment. Older women, those with high BMI and with more severe leakage also have a higher risk of failure. Neurourol. Urodynam. 36:426-431, 2017. © 2016 Wiley Periodicals, Inc.
authors.affiliation: University of Leicester, Department of Health Sciences, Leicester, United Kingdom.
authors.forename: Rhiannon K
authors.initials: RK
authors.lastname: Owen
authors.affiliation: University of Leicester, Department of Health Sciences, Leicester, United Kingdom.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Abrams
authors.affiliation: Women's and Children's CBU, University Hospitals of Leicester, Leicester, United Kingdom.
authors.forename: Christopher
authors.initials: C
authors.lastname: Mayne
authors.affiliation: Gynaecology, Rosie Hospital, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
authors.forename: Mark
authors.initials: M
authors.lastname: Slack
authors.affiliation: University of Leicester, Department of Health Sciences, Leicester, United Kingdom.|Women's and Children's CBU, University Hospitals of Leicester, Leicester, United Kingdom.
authors.forename: Douglas G
authors.initials: DG
authors.lastname: Tincello
mesh_terms: D000368:Aged; D019274:Botulinum Toxins, Type A / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D064804:Urological Agents / Q000627:therapeutic use*
chemical_list: D064804:Urological Agents; D019274:Botulinum Toxins, Type A
keywords: detrusor overactivity; efficacy; onabotulinum toxin; overactive bladder; treatment