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首页> 外文期刊>Revista Brasileira de Ginecologia e Obstetrícia >Tratamento da bexiga hiperativa n?o neurogênica com toxina botulínica A: revis?o sistemática e metanálise de ensaios clínicos prospectivos, randomizados e placebo-controlados *
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Tratamento da bexiga hiperativa n?o neurogênica com toxina botulínica A: revis?o sistemática e metanálise de ensaios clínicos prospectivos, randomizados e placebo-controlados *

机译：肉毒杆菌毒素A治疗非神经源性膀胱过度活动症：前瞻性，随机和安慰剂对照临床试验的系统评价和荟萃分析*

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We performed a systematic review and meta-analysis of randomized placebo-controlled trials that studied non-neurogenic overactive bladder patients who were treated with 100 units of onabotulinumtoxinA or placebo. The primary purpose of our study was to evaluate the clinical effectiveness with regard to urinary urgency, urinary frequency, nocturia, and incontinence episodes. Our secondary purpose consisted of evaluating the adverse effects. Our initial search yielded 532 entries. Of these, seven studies met all the inclusion criteria (prospective, randomized, placebo-controlled studies, ≥ 3 points on the Jadad scale) and were selected for analysis. For all primary endpoints, the toxin was more effective than placebo (p 0.0001; 95% confidence interval [95CI]), namely: urgency (mean difference = -2.07; 95CI = [-2.55-1.58]), voiding frequency (mean difference = - 1.64; 95CI = [-2.10-1.18]), nocturia (mean difference = -0.25; 95CI = [-0.39-0.11]) and incontinence episodes (mean difference = -2.06; 95CI= [-2.60-1.52]). The need for intermittent catheterization and the occurrence of urinary tract infection (UTI) were more frequent in patients treated with onabotulinumtoxinA than in patients treated with placebo (p 0.0001). Compared with placebo, onabotulinumtoxinA had significantly and clinically relevant reductions in overactive bladder symptoms and is associated with higher incidence of intermittent catheterization and UTI.
机译：我们对随机安慰剂对照试验进行了系统的回顾和荟萃分析，该试验研究了非神经源性活动过度的膀胱患者，这些患者接受了100单位的肉毒杆菌毒素A或安慰剂治疗。我们研究的主要目的是评估尿急，尿频，夜尿症和失禁发作的临床有效性。我们的次要目的是评估不利影响。我们的最初搜索产生了532个条目。其中有7项研究符合所有纳入标准（前瞻性，随机，安慰剂对照研究，Jadad评分≥3分），并被选择进行分析。对于所有主要终点，该毒素比安慰剂更有效（p <0.0001; 95％置信区间[95CI]），即：尿急（平均差异= -2.07; 95CI = [-2.55-1.58]），排尿频率（平均差异=-1.64; 95CI = [-2.10-1.18]），夜尿症（平均差异= -0.25; 95CI = [-0.39-0.11]）和失禁发作（平均差异= -2.06; 95CI = [-2.60-1.52]） ）。与使用安慰剂治疗的患者相比，用肉毒杆菌毒素A治疗的患者更需要间歇性导尿和发生尿路感染（UTI）（p <0.0001）。与安慰剂相比，onabotulinumumxinA具有明显的和临床上相关的膀胱过度活动症症状减轻，并且与间歇性导管插入术和UTI发生率更高相关。

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