Intrarectal Injections of Botulinum Toxin for the Treatment of Urge Fecal Incontinence: Long-Term Results of an FI-Toxin Cohort Study.

IF 2.9 3区 医学 Q1 CLINICAL NEUROLOGY
Neurogastroenterology and Motility Pub Date : 2025-07-01 Epub Date: 2025-04-06 DOI:10.1111/nmo.70025
Charlotte Desprez, Charlène Brochard, Véronique Vitton, Isabelle Etienney, Frank Zerbib, Gérard Amarenco, Francois Mion, Michel Queralto, Guillaume Gourcerol, Laurent Siproudhis, Henri Damon, Julie Philip, Elie Lacroix, André Gillibert, Anne-Marie Leroi
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引用次数: 0

Abstract

Background: The efficacy and safety of intrarectal botulinum toxin A (BoNT/A) injections in patients with urge fecal incontinence (FI) were evidenced in a large, multicenter, randomized, placebo-controlled study (FI-TOXIN). The aims of the present study were to evaluate the long-term efficacy and safety of intrarectal BoNT/A injections in a real-world setting in patients who participated in the FI-TOXIN study.

Methods: Data collected from patients who had previously participated in the FI-TOXIN study in 8 French centers from November 2015 to November 2020 were retrospectively analyzed. Given the transient effect of BoNT/A, patients who had received the first injection in the FI-TOXIN study could be re-injected if symptoms recurred. Information on re-injections, satisfaction of patients, severity of FI symptoms, adverse effects, and the switch to another treatment was retrospectively collected from medical charts between M6 (end of the double-blind phase) and M54 of the inclusion in the FI-TOXIN study.

Key results: Of the 191 patients in the initial FI-TOXIN cohort, 147 (77.0%) were included at M6. Between M6 and M54, 114 of these patients received 233 injections (68 first injections, 165 re-injections). Satisfaction information was available for 70 patients, of whom 43/70 (61.4%) were satisfied with all their injections. The treatment failed in 52/147 (35.4%) of the patients, with rejections of the treatment by patients due to insufficient perceived efficacy (34 patients), adverse effects or poor tolerance (11 patients), or switch to a surgical treatment (23 patients). Nonsevere adverse events were recorded after 45/233 (19.3%) injections. The two severe adverse events (cervical cancer and psychiatric hospitalization) were unrelated to the treatment.

Conclusions: Intrarectal injections of BoNT/A displayed moderate long-term efficacy without major adverse effects.

直肠内注射肉毒毒素治疗急迫性大便失禁:一项fi -毒素队列研究的长期结果。
背景:一项大型、多中心、随机、安慰剂对照研究(FI- toxin)证实了直肠内注射肉毒杆菌毒素A (BoNT/A)治疗急迫性大便失禁(FI)患者的有效性和安全性。本研究的目的是评估参与FI-TOXIN研究的患者在现实环境中直肠内注射BoNT/A的长期疗效和安全性。方法:回顾性分析2015年11月至2020年11月在法国8个中心参加过FI-TOXIN研究的患者的数据。鉴于BoNT/A的短暂作用,在FI-TOXIN研究中接受第一次注射的患者,如果症状复发,可以再次注射。从纳入FI-毒素研究的M6期(双盲期结束)至M54期的病历中回顾性收集关于再注射、患者满意度、FI症状严重程度、不良反应和转向另一种治疗的信息。关键结果:在初始fi -毒素队列的191例患者中,147例(77.0%)在M6时被纳入。在M6和M54期间,114例患者接受了233次注射(68次首次注射,165次再次注射)。70例患者获得满意信息,其中43/70(61.4%)患者对所有注射均满意。147例患者中有52例(35.4%)治疗失败,患者因感觉疗效不足(34例)、不良反应或耐受性差(11例)或改用手术治疗(23例)而排斥治疗。45/233(19.3%)注射后记录了非严重不良事件。两个严重不良事件(子宫颈癌和精神病院)与治疗无关。结论:直肠内注射BoNT/A长期疗效中等,无重大不良反应。
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来源期刊
Neurogastroenterology and Motility
Neurogastroenterology and Motility 医学-临床神经学
CiteScore
7.80
自引率
8.60%
发文量
178
审稿时长
3-6 weeks
期刊介绍: Neurogastroenterology & Motility (NMO) is the official Journal of the European Society of Neurogastroenterology & Motility (ESNM) and the American Neurogastroenterology and Motility Society (ANMS). It is edited by James Galligan, Albert Bredenoord, and Stephen Vanner. The editorial and peer review process is independent of the societies affiliated to the journal and publisher: Neither the ANMS, the ESNM or the Publisher have editorial decision-making power. Whenever these are relevant to the content being considered or published, the editors, journal management committee and editorial board declare their interests and affiliations.
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