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Tsubouchi K, Maeda T, Emoto T, Aoyagi C, Matsuoka W, Yamazaki F, Nakagawa C, Fukuhara Y, Tominaga K, Gunge N, Miyazaki T, Okabe Y, Matsuzaki H, Nakamura N, Arima H, Haga N. Improvement of medication adherence for desmopressin by adjusting the prescription dosage in male patients with overactive bladder: A claims database analysis. Neurourol Urodyn 2024. [PMID: 38979828 DOI: 10.1002/nau.25541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/22/2024] [Accepted: 06/28/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVES Desmopressin is widely used for nocturia in patients with nocturnal polyuria. We investigated the continuation rate and adherence for desmopressin in patients with overactive bladder and nocturia using a claims database and evaluated factors that improved adherence. METHODS Patients with nocturia in a Japanese claims database who started desmopressin between September 2019 and July 2021 were evaluated. Drug persistence was assessed using the Kaplan-Meier method for initial prescription of desmopressin. The proportion of days covered (PDC) was also evaluated among patients with prescription persistence. Multivariate analysis was performed using logistic regression analysis to identify factors predicting adherence to desmopressin. RESULTS The study included 72,888 patients entered into Japan Medical Data Center (JMDC) database between September 2019 and July 2021. For the 236 patients prescribed desmopressin formulations, mean prescription duration was 114 days. Among the total cases, 90 (38.1%) cases were prescribed only once, mean PDC was 0.60, and the number of high-adherence patients (PDC ≥ 0.80) was 108 (45.8%). Desmopressin prescription doses were fixed in 216 patients and adjusted in 20 patients. Multivariate analysis identified prescription dose adjustment for desmopressin as significantly associated with high PDC. CONCLUSION Desmopressin showed a 38% dropout rate after the first dose. However, high medication continuation and high medication adherence rates (PDC) could be maintained with prescription adjustments. Careful patient monitoring and appropriate adjustment of the desmopressin dosage appear to be important factors in improving nocturia.
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Affiliation(s)
- Kazuna Tsubouchi
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Toshiki Maeda
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Taiki Emoto
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Chikao Aoyagi
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Wataru Matsuoka
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Fumihiro Yamazaki
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Chizuru Nakagawa
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yuichiro Fukuhara
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kosuke Tominaga
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Naotaka Gunge
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takeshi Miyazaki
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Yu Okabe
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hiroshi Matsuzaki
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Nobuyuki Nakamura
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Nobuhiro Haga
- Department of Urology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Li J, Liu W, Tang C, Pan H, Song C. Clinical efficacy and safety analysis of type A botulinum toxin in the treatment of adolescents with refractory overactive bladder. Medicine (Baltimore) 2024; 103:e38803. [PMID: 38968476 PMCID: PMC11224879 DOI: 10.1097/md.0000000000038803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/12/2024] [Indexed: 07/07/2024] Open
Abstract
The objective of this study was to assess the clinical effectiveness and safety of type A botulinum toxin in the treatment of refractory overactive bladder in adolescents. We conducted a retrospective analysis of 37 adolescent patients with refractory overactive bladder who were treated at the Urology Department of Hangzhou Third People's Hospital between January 2018 and August 2023. These patients received intravesical injections of type A botulinum toxin at a concentration of 10 U/mL, with an average of 20 injection points. We recorded changes in urination diaries and urodynamic parameters both before and 1 month after treatment. After 1 month of treatment, significant improvements were observed in several parameters, when compared to the pretreatment values. These included daytime frequency of urination (11.13 ± 6.45), average single void volume (173.24 ± 36.48) mL, nighttime frequency of urination (2.43 ± 0.31), urgency episodes (3.12 ± 0.27), initial bladder capacity (149.82 ± 41.34) mL, and maximum bladder capacity (340.25 ± 57.12) mL (all P < .001). After the first treatment, 5 patients had mild hematuria, 4 patients had urinary tract infection, and 1 patient had urinary retention, which was relieved after catheterization. No serious complications or adverse reactions were observed in other patients. The follow-up period ranged from 6 to 18 months, and the duration of efficacy varied from 2 to 8 months. Eight patients who initially had treatment failure achieved symptom relief after reinjection. In adolescents with refractory overactive bladder who do not respond well to conventional drug therapy, type A botulinum toxin can be administered safely and effectively. It significantly improves lower urinary tract symptoms and enhances the quality of life for these patients.
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Affiliation(s)
- Junhua Li
- Department of Urology, Hangzhou Third People’s Hospital, Hangzhou, P. R. China
| | - Wei Liu
- Department of Surgery, Zhejiang Medical & Health Group Hangzhou Hospital, Hangzhou, P. R. China
| | - Chenhao Tang
- Department of Urology, Hangzhou Third People’s Hospital, Hangzhou, P. R. China
| | - Huixian Pan
- Department of Urology, Hangzhou Third People’s Hospital, Hangzhou, P. R. China
| | - Chen Song
- Department of Urology, Hangzhou Third People’s Hospital, Hangzhou, P. R. China
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Wu PC, Hsiao SM, Lin HH. Prevalence and predictors of nocturnal polyuria in females with overactive bladder syndrome. World J Urol 2021; 40:519-527. [PMID: 34762173 DOI: 10.1007/s00345-021-03865-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/12/2021] [Indexed: 12/28/2022] Open
Abstract
PURPOSE To describe the prevalence and predictors of nocturnal polyuria (NP) in women with overactive bladder syndrome (OAB). METHODS Between July 2009 and January 2018, women with OAB were enrolled. NP was defined when the nocturnal polyuria index (NPI) (nighttime voided volume over 24-h voided volume) was > 33% (NPI33) in women ≥ 65 years-old and > 20% (NPI20) in women < 65 years old. Repeated analysis was also performed for NP defined by the NPI33 definition at all ages. RESULTS A total of 1071 women with OAB were analyzed. The overall prevalence of NP was 30% (319/1071), with the highest prevalence in women in the perimenopausal period (46-50 years old), while NP was diagnosed by age-dependent NPI. The overall prevalence of NP was 12% (128/1071), with an increasing trend with increasing age, while NP was diagnosed by the NPI33 definition only. Daytime frequency and nocturia episodes were both predictors for NP in both definitions. Receiver operating characteristic curve analysis revealed that more than 5 nocturia episodes noted in the 3-day bladder diary were an optimal cutoff value to predict nocturnal polyuria [(sensitivity = 85.6%, specificity = 61.0%; area = 0.80, 95% CI 0.77-0.82) and (sensitivity = 88.3%, specificity = 65.9%; area = 0.83, 95% CI 0.80-0.85), respectively, in the two definitions]. CONCLUSIONS NP is common in women with OAB, especially in women with more than 5 nocturia episodes in their 3-day bladder diaries, and adjuvant therapy for better treatment efficacy is needed.
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Affiliation(s)
- Pei-Chi Wu
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, No. 8, Chung-Shan South Road, Taipei, 100, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.,Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan
| | - Ho-Hsiung Lin
- Department of Obstetrics and Gynecology, National Taiwan University College of Medicine and Hospital, No. 8, Chung-Shan South Road, Taipei, 100, Taiwan. .,Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, Banqiao, New Taipei, Taiwan.
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