{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T21:08:18Z","timestamp":1771967298704,"version":"3.50.1"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction and Hypothesis<\/jats:title><jats:p>Patients with overactive bladder (OAB) often undergo prolonged treatment with one or more oral OAB medications. OnabotulinumtoxinA (onabotA), a type A botulinum toxin, may provide an appropriate alternative to oral treatments in patients intolerant of or refractory to one or more oral OAB medications. The GRACE study demonstrated real\u2010world benefits of onabotA treatment for OAB in patients refractory to oral medications. This exploratory post hoc analysis of data from the GRACE study aims to determine if treatment history impacts benefit from treatment with onabotA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a subanalysis of the GRACE study, a prospective observational study (NCT02161159) that enrolled patients with symptomatic OAB inadequately managed by at least one oral OAB medication. Patients had a treatment history of one or more anticholinergics (AC) and\/or \u03b2\u20103 adrenoreceptor agonists (\u03b2\u20103) for relief of OAB; results were stratified according to treatment history. Patients in this analysis elected to discontinue oral medications upon treatment with onabotA. Safety was followed for 12 months in all patients that received at least 1 dose of onabotA; efficacy was determined over a 12\u2010week period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to baseline levels, significant reductions in urinary incontinence\u00a0(UI), urgency, micturition, and nocturia were noted as early as 1\u00a0week and were sustained at 12 weeks, regardless of the type and number of oral medications taken before treatment with onabotA. At 12 weeks post\u2010onabotA, the mean change from baseline UI episodes\/day for those with a treatment history of only one AC was \u22122.4 (<jats:italic>n<\/jats:italic>\u2009=\u200943, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.001); more than one AC, \u22122.4 (<jats:italic>n<\/jats:italic>\u2009=\u200952, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.001); one \u03b2\u20103, \u22123.3 (<jats:italic>n<\/jats:italic>\u2009=\u200912, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05); at least one AC and at least one \u03b2\u20103, \u22123.2 (<jats:italic>n<\/jats:italic>\u2009=\u200956, <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.001). Pad and liner use was significantly decreased at 12 weeks post\u2010onabotA across all treatment history groups. Reductions in diaper pant use varied, with less of a reduction in patients with a treatment history of more than one AC compared to patients with a history of at least one AC and one \u03b2\u20103 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) or those with a history of only one AC (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><jats:p>Overall, a total of 253\/288 of patients (88%) reported improvements on the treatment benefit scale 12 weeks after treatment with onabotA, regardless of type and number of prior oral medications. In the population of patients that received at least one dose of onabotA (<jats:italic>N<\/jats:italic>\u2009=\u2009504), 57 adverse events were reported in 38 patients (7.5%); 9 were serious (1.8%). Urinary retention was reported in 5 patients (1.0%); 1 was severe (0.2%). Symptomatic urinary tract infection was reported in 2 patients (0.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this exploratory post hoc analysis of real\u2010world data from the GRACE study, there were few significant differences in outcomes based on the type and number of prior oral medications. Thus, patients who are refractory to one or more oral OAB medications may benefit from earlier treatment with onabotA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25221","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T12:07:09Z","timestamp":1685621229000},"page":"1203-1213","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["One treatment with onabotulinumtoxinA relieves symptoms of overactive bladder in patients refractory to one or more oral medications"],"prefix":"10.1002","volume":"42","author":[{"given":"Elisabeth","family":"Farrelly","sequence":"first","affiliation":[{"name":"Department of Surgical and Perioperative Sciences, Urology and Andrology Ume\u00e5 University Ume\u00e5 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2302-1344","authenticated-orcid":false,"given":"Rizwan","family":"Hamid","sequence":"additional","affiliation":[{"name":"University College London Hospitals London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria\u2010Fernanda","family":"Lorenzo\u2010Gomez","sequence":"additional","affiliation":[{"name":"University Hospital of Salamanca Salamanca Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heinrich","family":"Schulte\u2010Baukloh","sequence":"additional","affiliation":[{"name":"Department of Urology Charit\u00e9 University Hospital Berlin Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Yu","sequence":"additional","affiliation":[{"name":"AbbVie Inc. North Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anand","family":"Patel","sequence":"additional","affiliation":[{"name":"AbbVie Inc. Marlow UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Nelson","sequence":"additional","affiliation":[{"name":"AbbVie Inc. 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