Poster, Podium & Video Sessions
Presentation Authors: Rui Pinto*, Daniel Costa, Afonso Morgado, Pedro Pereira, João Silva, Francisco Cruz, Porto, Portugal
Introduction: Pain relief is the key corner of Bladder Pain Syndrome/Interstitial cystitis (BPS/IC) management. The present prospective, randomized, double-blind, placebo-controlled (saline) clinical trial aims to evaluate the analgesic efficacy and safety of intra-trigonal injection of OnaBotA in patients with BPS/IC refractory to common treatment.
Methods: Nineteen women with a pain score more than 4 in a 0-10 visual analogue scale (VAS) were enrolled. Patients were randomized to receive 100 Units (U) in 10 ml of saline (n=10) of OnaBotA (Botox) or the equivalent volume of saline (n=9) in 10 points of the bladder trigone under cystoscopic guidance and general anaesthesia. The primary outcome was VAS at 12 weeks (w). Secondary outcomes included VAS at 4 and 8w, day and night time frequency in a 3-day bladder diary, O’Leary-Sant score (OSS) and QoL 4, 8 and 12w after treatment. Treatment Benefit Scale (TBS) was evaluated at 12w. Side effects were registered, in particular post-void residual volumes (PVR) and urinary tract infections (UTIs).
Results are presented as mean values ± standard deviation. T-test was used to compare the 2 arms at each time point.
Results: Mean age was identical (OnaBotA: 44±10y vs Saline: 48±11y). According to ESSIC classification each arm had 3 cases with Hunner lesions. At baseline the two groups were balanced for all clinical variables (table 1).
At 12w VAS for pain was significantly lower in OnaBotA arm (3.1±2.8 versus 5±2.2, p<0.05). VAS was numerically lower in OnaBotA arm also at 4 and 8w (table 1). OSS, and QoL were significantly better in the OnabotA arm at 8 and 12w (table 1). Urinary frequency was numerically lower in OnaBotA arm (table 1). Treatment Benefit Scale was 1.9±0.9 in the OnabotA group versus 3.1±0.8 in the Saline group (p<0.05).
Five UTIs occurred, 2 in Saline and 3 in the OnaBotA arms. No cases of voiding dysfunction were observed.
Conclusions: This RCT demonstrates that intra-trigonal injection of 100U of OnaBotA is significantly better than placebo to reduce pain and to improve QoL in patients with refractory BPS/IC. Adverse events associated with intra-trigonal injection of 100U of OnaBotA were mild. No cases of urinary retention occurred.
Source Of Funding: Allergan
Faculdade de Medicina Universidade do Porto