Document Detail


Treatment outcomes and resource use of patients with neurogenic detrusor overactivity receiving botulinum toxin A (BOTOX) therapy in Germany.
MedLine Citation:
PMID:  19693509     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To evaluate treatment outcomes and resource consumption of patients with neurogenic detrusor overactivity (NDO) before and after botulinum toxin A (Botox) therapy in Germany. METHODS: In a multi-center, cross-sectional, retrospective cohort study, data of patients with NDO 12 months before and after the first Botox therapy were analyzed. RESULTS: 214 patients (mean age 38 +/- 14.8 years, 145 male, 69 female) with NDO due to spinal cord injury (81%); myelomeningocele (14%), or Multiple Sclerosis (5%) from seven hospitals were included. Mean interval between treatments was 8 months. Following treatment, mean maximum detrusor pressure, maximum cystometric capacity and detrusor compliance improved significantly. Prior to Botox therapy, 68% reported urinary tract infections (UTI), 63% had incontinence episodes, and 58% used incontinence aids. These numbers decreased significantly (p < 0.05) after treatment to 28, 33, and 28%, respectively. In patients using incontinence aids, mean costs per patient decreased from 2euro to 1euro per day, whereas the mean cost of drugs to treat UTIs per patient decreased from 163euro to 80euro per year, respectively. CONCLUSION: This is the first study demonstrating the clinical usefulness of Botox therapy in clinical practice. Successful treatment resulted in lower costs for NDO associated morbidity due to less need for incontinence aids and UTI medication.
Authors:
Björn Wefer; Birgit Ehlken; Jörn Bremer; Harald Burgdörfer; Burkhard Domurath; Christian Hampel; Johannes Kutzenberger; Christoph Seif; Karl D Sievert; Karin Berger; Jürgen Pannek
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2009-08-20
Journal Detail:
Title:  World journal of urology     Volume:  28     ISSN:  1433-8726     ISO Abbreviation:  World J Urol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-08-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8307716     Medline TA:  World J Urol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  385-90     Citation Subset:  IM    
Affiliation:
Klinik für Urologie und Kinderurologie, Universitätsklinikum Schleswig-Holstein, Kiel, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Botulinum Toxin Type A / economics,  therapeutic use*
Chi-Square Distribution
Cohort Studies
Cost of Illness*
Cost-Benefit Analysis
Cross-Sectional Studies
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Follow-Up Studies
Germany
Humans
Injections, Intramuscular
Male
Meningomyelocele / complications
Middle Aged
Multiple Sclerosis / complications
Probability
Quality of Life
Retrospective Studies
Severity of Illness Index
Spinal Cord Injuries / complications
Statistics, Nonparametric
Treatment Outcome
Urinary Bladder, Neurogenic / diagnosis,  drug therapy*,  economics,  etiology
Urinary Bladder, Overactive / diagnosis,  drug therapy*,  economics*,  etiology
Urodynamics
Young Adult
Chemical
Reg. No./Substance:
0/Botulinum Toxin Type A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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