Long-Term Treatment with OnabotulinumtoxinA Results in Consistent, Durable Improvements in Health-Related Quality of Life in Patients with Overactive Bladder

Purpose To present the long-term effects of repeat onabotulinumtoxinA 100U treatment on health-related quality of life in overactive bladder patients with urinary incontinence who had an inadequate response to/were intolerant of an anticholinergic. Materials and Methods Patients completing either of two 24-week, phase III trials could enter a 3-year extension study and request multiple onabotulinumtoxinA 100U treatments as needed. Results for the I-QOL (Incontinence-Quality of Life) and KHQ (King’s Health Questionnaire) are reported for upto 6 treatments. Consistency of response with repeated onabotulinumtoxinA treatments was evaluated by classifying patients by I-QOL response to the first treatment and analyzing responses for treatments 2-6. Results After onabotulinumtoxinA treatments 1-6, improvements in I-QOL scores were consistently 2-3 times the minimally important difference, and improvements in KHQ Role Limitations and Social Limitations domain scores were 5-6 and 3-4 times the minimally important difference. Most patients achieved/exceeded the minimally important difference for I-QOL and KHQ domain scores. Furthermore, 72.9% of patients who achieved/exceeded the minimally important difference for I-QOL after treatment 1 did so in all subsequent treatments. Over one-third (38.3%) of patients with a poor response after treatment 1 achieved improvements greater than the minimally important difference in all subsequent treatments. Conclusions In overactive bladder patients with incontinence, consistent and clinically meaningful improvements in health-related quality of life were observed with repeated onabotulinumtoxinA 100U treatments. A positive response after treatment 1 tended to predict similar responses to subsequent treatments, whereas lack of response to treatment 1 did not preclude positive response(s) to later treatments.