Concomitant Botulinum Toxin Injections for Neurogenic Detrusor Overactivity and Spasticity—A Retrospective Analysis of Practice and Safety-Reference-Cited by-同舟云学术

Concomitant Botulinum Toxin Injections for Neurogenic Detrusor Overactivity and Spasticity—A Retrospective Analysis of Practice and Safety

Published:2024-05-28 Issue:6 Volume:16 Page:252
ISSN:2072-6651
Container-title:Toxins
language:en
Short-container-title:Toxins

Author:

Leilaz Arnaud¹²,Joussain Charles³⁴,Denys Pierre³⁴^ORCID,Bensmail Djamel¹⁴,Levy Jonathan¹⁴^ORCID

Affiliation:

1. Spinal Unit, Department of Physical and Rehabilitation Medicine, Raymond Poincaré Teaching Hospital, APHP Paris Saclay, 92380 Garches, France

2. School of Medicine, Sorbonne University, 75013 Paris, France

3. Neurourology Unit, Department of Physical and Rehabilitation Medicine, Raymond Poincaré Teaching Hospital, APHP Paris Saclay, 92380 Garches, France

4. INSERM 1179, University of Versailles Saint-Quentin-en-Yvcelines, 78180 Montigny-le-Bretonneux, France

Abstract

As multiple indications for botulinum toxin injections (BTIs) can coexist for neurological patients, there are to date no description of concomitant injections (CIs) to treat both spasticity and neurogenic detrusor overactivity incontinence (NDOI) in patients with spinal cord injuries (SCIs) and multiple sclerosis (MS). We therefore identified patients followed at our institution by health data hub digging, using a specific procedure coding system in use in France, who have been treated at least once with detrusor and skeletal muscle BTIs within the same 1-month period, over the past 5 years (2017–2021). We analyzed 72 patients representing 319 CIs. Fifty (69%) were male, and the patients were mostly SCI (76%) and MS (18%) patients and were treated by a mean number of CIs of 4.4 ± 3.6 [1–14]. The mean cumulative dose was 442.1 ± 98.8 U, and 95% of CIs were performed within a 72 h timeframe. Among all CIs, five patients had symptoms evocative of distant spread but only one had a confirmed pathological jitter in single-fiber EMG. Eleven discontinued CIs for surgical alternatives: enterocystoplasty (five), tenotomy (three), intrathecal baclofen (two) and neurotomy (one). Concomitant BTIs for treating both spasticity and NDOI at the same time appeared safe when performed within a short delay and in compliance with actual knowledge for maximum doses.

Publisher

MDPI AG

Link

https://www.mdpi.com/2072-6651/16/6/252/pdf

Reference28 articles.

1. Merz Pharmaceuticals (2024, February 28). Xeomin® (incobotulinumtoxinA) [Package Insert]. U.S. Food and Drug Administration Website, Available online: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/125360s097lbl.pdf.

2. Ipsen Biopharmaceuticals, Inc. (2024, February 28). Dysport® (abobotulinumtoxinA) [Package Insert]. U.S. Food and Drug Administration Website, Available online: https://www.accessdata.fda.gov/drugsatfda_docs/label/2023/125274s125lbl.pdf.

3. Allergan (2024, February 28). BOTOX® (onabotulinumtoxinA) [Package Insert]. U.S. Food and Drug Administration Website, Available online: https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/103000s5232lbl.pdf.

4. EMA (2024, February 28). European Public Assessment Report (EPAR) for Xeomin. [Internet]. Amsterdam: European Medicines Agency. Available online: https://www.ema.europa.eu/en/medicines/human/referrals/xeomin.

5. EMA (2024, February 28). European Public Assessment Report (EPAR) for BOTOX. [Internet]. Amsterdam: European Medicines Agency. Available online: https://www.ema.europa.eu/en/medicines/human/referrals/botox.