Clinical application of intravesical botulinum toxin type A for overactive bladder and interstitial cystitis

Objective: to assess the clinical and economic efficiency and impact on the budget when using the drug Mirabegron in the treatment of an overactive bladder. Materials and methods. Study design — retrospective analysis of published data. Pharmacoeconomic analysis methods — cost analysis, clinical and economic analysis, budget impact analysis. Results. Despite the fact that the drug Mirabegron for the treatment of overactive bladder is less effective in comparison with the use of the botulinum toxin type A-hemagglutinin complex drug, the clinical and economic analysis showed that within the horizon of 12 months the use of the drug Mirabegron will require 66.8 % less costs. Analysis of the impact on the budget showed that when using the drug Mirabegron from the first year in 100 % of patients, the decrease in the burden on the budget will be 66.8 %. Gradual provision of Mirabegron to patients over 3 years instead of Botulinum toxin type A-hemagglutinin complex will reduce the burden on the budget by 44.4 % in 3 years. Sensitivity analysis showed that the results obtained are resistant to changes in prices for compared drugs and a decrease in the volume of therapy with botulinum toxin type A-hemagglutinin complex. Conclusion. The use of the drug Mirabegron in the treatment of patients with an overactive bladder is pharmacoeconomically justified. The inclusion of Mirabegron in the lists of medicines, the costs of which are subject to state reimbursement, is advisable.

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Botulinum toxin type A in the treatment of bladder pain syndrome in women: initial results

Urologicheskie vedomosti ◽

10.17816/uroved825-10 ◽

2018 ◽

Vol 8 (2) ◽

pp. 5-10

Author(s):

Salman H Al-Shukri ◽

Igor V Kuzmin ◽

Margarita N Slesarevskaya ◽

Yuriy A Ignashov

Keyword(s):

Botulinum Toxin ◽

Interstitial Cystitis ◽

Botulinum Toxin Type A ◽

Pain Syndrome ◽

Type A ◽

Botulinum Toxin Type ◽

Bladder Pain Syndrome ◽

Visual Analogue Pain Scale ◽

Bladder Pain ◽

Initial Results

We present the results of botulinum toxin type A (BT-A) treatment in 49 women (aged 41-65 years) with bladder pain syndrome. Previously, all patients underwent oral and intravesical drug therapy in addition to hydrodistention of the bladder without significant clinical effect. BT-A at a dose of 100 U (20 points at 5 units) was injected into the bladder under general anesthesia. Treatment results were evaluated 3 months after the treatment using specialized questionnaires such as the Pelvic Pain and Urgency/Frequency (PUF) Scale, O’Leary-Sant Symptom Index and Interstitial Cystitis Scale, visual analogue pain scale (VAS), and urinary diaries. Remarkably, the treatment was effective in 46 (93.8%) patients. By the end of the third month after the BT-A injection, the PUF Scale score, the O’Leary-Sant Symptom and Interstitial Cystitis Scale, and VAS reduced by 41.3%, 32%, and 34%, respectively, and urination frequency decreased by 38.5%. Thus, BT-A is an effective method for treating bladder pain syndrome in patients who are refractory to other treatment methods. (For citation: Al-Shukri SH, Kuzmin IV, Slesarevskaya MN, Ignashov YuA. Botulinum toxin type A in the treatment of bladder pain syndrome in women: initial results. Urologicheskie vedomosti. 2018;8(2):5-10. doi: 10.17816/uroved825-10).

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