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Urologists in some communities are offering off-label botulinum toxin (Botox) injections to treat overactive bladder, but how effective is this intervention? In an industry-sponsored study — reported by the authors to be “the first large, placebo controlled, multicenter, dose ranging study” — researchers randomized 313 patients with idiopathic overactive bladder and urgency incontinence to receive either placebo or one of five doses of onabotulinumtoxinA, delivered by injections into the detrusor muscle via cystoscopy.
The primary efficacy endpoint was change from baseline in the number of weekly episodes of urge incontinence at week 12. The mean decreases from baseline were 17 episodes weekly in the placebo group and 21, 18, 23, 20, and 19 …