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Introduction and Hypothesis <p>Overactive bladder (OAB) has higher prevalence and increased morbidity in older people. Owing to side effects and inefficacy of OAB medications, patients frequently choose onabotulinumtoxin A intradetrusor injections (BTX-A). There is limited research investigating efficacy and adverse event (AE) rates of BTX-A in older female populations. Our objective was to evaluate rates of BTX-A discontinuation, treatment failure, UTI, and retention in women ≥ 80 compared to younger cohorts.</p> Methods <p>This retrospective cohort study included a convenience sample of women who underwent in-office BTX-A for OAB between 1/2014 and 12/2020. Data was analyzed with Kruskal–Wallis, ANOVA, chi-square, and Fisher’s exact tests.</p> Results <p>Overall, 547 women were included with 215 (39%) &lt; 65&#xa0;years old, 249 (46%) 65–79, and 83 (15%) ≥ 80. When comparing age cohorts, rate of BTX-A discontinuation increased with age (54% at &lt; 65, 58% 65–79, 72% ≥ 80, <i>p</i> = 0.01) with no significant difference in discontinuation due to ineffectiveness (19% &lt; 65, 28% 65–79, 23% ≥ 80, <i>p</i> = 0.22). Those &lt; 65 had the lowest rate of UTI (19%), but UTI rate was the same for women 65–79 (29%) and ≥ 80 (29%, <i>p</i> &lt; 0.01). Rates of retention were highest in women 65–79 (8% &lt; 65, 17% 65–79, 8% ≥ 80, <i>p</i> = 0.01).</p> Conclusions <p>Women ≥ 80&#xa0;years old were most likely to discontinue BTX-A but discontinuing for ineffectiveness was the same regardless of age. Women &gt; 65 are more likely to experience UTI after BTX-A; however, AEs do not significantly increase in women ≥ 80&#xa0;years old, making BTX-A a good option in elderly patients.</p>

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Intradetrusor OnabotulinumtoxinA Safety and Efficacy in Patients 80 Years and Older: A Retrospective Cohort Study

  • 期刊论文

  • 发表日期：

    2025年12月12日

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  • Faith E. Dunn,
  • Bayley Clarke,
  • Annemarie Newark,
  • Arthur C. Arcaz,
  • Nancy Ringel,
  • Alexis A. Dieter,
  • Katherine L. Woodburn

摘要

Introduction and Hypothesis

Overactive bladder (OAB) has higher prevalence and increased morbidity in older people. Owing to side effects and inefficacy of OAB medications, patients frequently choose onabotulinumtoxin A intradetrusor injections (BTX-A). There is limited research investigating efficacy and adverse event (AE) rates of BTX-A in older female populations. Our objective was to evaluate rates of BTX-A discontinuation, treatment failure, UTI, and retention in women ≥ 80 compared to younger cohorts.

Methods

This retrospective cohort study included a convenience sample of women who underwent in-office BTX-A for OAB between 1/2014 and 12/2020. Data was analyzed with Kruskal–Wallis, ANOVA, chi-square, and Fisher’s exact tests.

Results

Overall, 547 women were included with 215 (39%) < 65 years old, 249 (46%) 65–79, and 83 (15%) ≥ 80. When comparing age cohorts, rate of BTX-A discontinuation increased with age (54% at < 65, 58% 65–79, 72% ≥ 80, p = 0.01) with no significant difference in discontinuation due to ineffectiveness (19% < 65, 28% 65–79, 23% ≥ 80, p = 0.22). Those < 65 had the lowest rate of UTI (19%), but UTI rate was the same for women 65–79 (29%) and ≥ 80 (29%, p < 0.01). Rates of retention were highest in women 65–79 (8% < 65, 17% 65–79, 8% ≥ 80, p = 0.01).

Conclusions

Women ≥ 80 years old were most likely to discontinue BTX-A but discontinuing for ineffectiveness was the same regardless of age. Women > 65 are more likely to experience UTI after BTX-A; however, AEs do not significantly increase in women ≥ 80 years old, making BTX-A a good option in elderly patients.