The Efficacy and Safety of OnabotulinumtoxinA with Different Dosages for the Treatment of Overactive Bladder Syndrome: A Systematic Review and Meta-analysis

OnabotulinumtoxinA therapy has become widely used in overactive bladder syndrome (OAB), and many relevant articles have been published, however, there is no consensus regarding the clinical effect of onabotulinumtoxinA with the different dosages. Therefore, we conducted this meta-analysis to assess the efficacy and safety of 100 U, 200 U and 300 U onabotulinumtoxinA for the treatment of (OAB). In this project, We performed a comprehensive literature search, which was performed using EMBASE, PubMed, Cochrane database, and Google Scholar for randomized controlled trials (from inception to February 2017). As a result, fourteen studies with 1999 participants were selected. For the efficacy, 200 U of OnabotulinumtoxinA was significantly superior to 100 U, especially in the maximum cystometric capacity (MCC) and maximum detrusor pressure (MDP). Also, its subjective cure rate showed the same tendency. There were no statistical differences between 200 U and 300 U in MCC, MDP and subjective cure rate. For the adverse events, there were no statistical differences among 100 U, 200 U and 300 U OnabotulinumtoxinA in urinary tract infection (UTI) and urinary retention. Therefore, in our study. Compared to 100 U OnabotulinumtoxinA, 200 U OnabotulinumtoxinA has better efficacy while maintaining safety. Although 200 U OnabotulinumtoxinA is comparable to 300 U OnabotulinumtoxinA in terms of safety and efficacy, 200 U OnabotulinumtoxinA is a cost-effective intervention and may appear to be the optimal dosage for OAB populations.