BOTOX(R) has been licensed by the Medicines and Healthcare Products Regulatory Agency (MHRA) for the management of urinary incontinence in adult patients with neurogenic detrusor overactivity (NDO) due to subcervical spinal cord injury (SCI) (traumatic or non-traumatic) or multiple sclerosis (MS), who are not adequately managed with anticholinergics. The marketing authorisation is specific for Allergan’s botulinum toxin type A product and is a milestone in bringing this treatment to people living with MS or SCI who have urinary leakage, providing them with a long-term solution for bladder control.
Approximately 140,000 people in the UK are living with MS or SCI. Between 75-80% of people with MS and 60-80% of people with SCI will suffer from some degree of bladder dysfunction including urinary incontinence. Urinary leakage in patients with MS or SCI is frequently caused by a condition called neurogenic detrusor overactivity, which results in involuntary contractions of the bladder during the filling stage when the bladder should be relaxed. This overactivity can lead to urinary incontinence (uncontrolled urinary leakage). Current treatment options include oral medications that need to be taken daily.
However, less than 30% of patients manage to stay on oral medication for longer than a period of 12 months. If oral medications fail to control the leakage, then patients may require surgical intervention. Targeted injections with Allergan’s botulinum toxin type A product into the bladder muscle have been shown to reduce the involuntary contractions and increase bladder capacity. In turn, this reduces the number of urinary leakage episodes and may even stop leakage altogether in some patients.
“Historically, the management of urinary incontinence due to NDO has relied on daily medications. However, many patients find that daily medications are difficult to adhere to and sometimes these medications have limited effect,” said Professor Christopher Chapple, Urology Department, Royal Hallamshire Hospital, Sheffield NHS Trust.
Many people who have neurological diseases and are suffering from urinary incontinence remain undiagnosed and untreated. Amy Bowen, Director of Service Development at the MS Trust, explained, “For many people with MS, urinary leakage is frequently seen as a taboo subject with patients often reluctant or too embarrassed to talk about the symptoms to anyone. As a result, many people with MS can feel distressed, socially isolated and that they lack of control over their condition. It is a really positive development that there is now an additional, effective treatment option to help manage this difficult problem. Hopefully, more people with MS who are struggling with urinary leakage will feel confident to discuss these symptoms with their MS specialists and find the treatment option that is right for them.”