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Małkowski M, Almgren-Rachtan A, Olszanecka-Glinianowicz M, Chudek J, Chłosta P. Regular and Irregular Use and Reasons for Discontinuation of Solifenacin Therapy in Patients with Overactive Bladder Managed by Urologists. Pharmaceuticals (Basel) 2024; 17:116. [PMID: 38256949 PMCID: PMC10820369 DOI: 10.3390/ph17010116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/24/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Solifenacin, a selective muscarinic receptor antagonist, is one of the best-tolerated and most effective medicines that relieve storage symptoms in patients with an overactive bladder (OAB). However, the persistence of solifenacin in daily clinical practice remains far below that reported in clinical trials. This study aimed to analyze the adherence of patients to the therapy and the reasons for solifenacin discontinuation and non-regular use in OAB patients managed by urologists. Data concerning non-compliance and the discontinuation of solifenacin, along with the reasons, were collected during two consecutive visits for 64,049 OAB outpatients. Over the two visits, 81.6% of the patients continued therapy, and 88.6% were taking solifenacin regularly. An age ≥ 75 yrs., the male sex, a rural or small-city dwelling, and a prescription of ≥10 mg predicted therapy continuation. The female sex, a higher education, a short or long duration of an OAB, and a non-idiopathic OAB predicted regular use. The persistence of nycturia and urinary incontinence during therapy predicted both discontinuation and non-regular use. Dissatisfaction with therapy was the most frequent reason for discontinuation. In conclusion, an initial prescription of solifenacin at a low dose reduces the chance of OAB symptom improvement and results in more frequent discontinuation. A high rate of discontinuation related to dissatisfaction suggests unrealistic expectations for OAB patients and insufficient education by urologists.
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Affiliation(s)
| | - Agnieszka Almgren-Rachtan
- Department of Pharmacovigilance, Europharma Research & Science Centre Co. Ltd., 40-061 Katowice, Poland
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Medical Faculty in Katowice, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Jerzy Chudek
- Department of Internal Medicine and Oncological Chemotherapy, Medical Faculty in Katowice, Medical University of Silesia, 40-055 Katowice, Poland
| | - Piotr Chłosta
- Department of Urology, Jagiellonian University Medical College, 31-008 Krakow, Poland;
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Raman G, Tunnicliffe D, Lai E, Bennett T, Caldwell P. Safety and tolerability of solifenacin in children and adolescents with overactive bladder- a systematic review. J Pediatr Urol 2023; 19:19.e1-19.e13. [PMID: 36336627 DOI: 10.1016/j.jpurol.2022.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Solifenacin is an anticholinergic that is used to treat overactive bladder syndrome (OAB) in children. It is important to ascertain the safety and tolerability of solifenacin in the paediatric population as solifenacin offers an alternative, is more bladder specific, and should have less anticholinergic side effects than other therapies. OBJECTIVE The aim of this study is to systematically evaluate the safety and tolerability of solifenacin in children and adolescents with OAB. STUDY DESIGN We included studies that reported the safety and tolerability of solifenacin in children and adolescents. All study types were included. Electronic searches were conducted in Ovid MEDLINE, Ovid Embase, TRIP, CINAHL and ICTRP on the 18th of January 2022. Risk of bias was assessed with the Cochrane Risk of Bias tool 2.0 (ROB-2) for randomised controlled trials (RCTs) and the Newcastle-Ottowa scale for cohort studies. RESULTS A total of twelve studies including two RCTs were included in this review. Results from the meta-analysis of RCTs showed the commonest side effects were constipation (RR 3.5, 95%CI 0.9-13.7) and dry mouth (RR 3.1 95%CI 0.2-53). In terms of tolerability, the effect estimate of ceasing solifenacin due to an adverse effect was 2.7 (95%CI 0.8-9.1). Within the cohort studies, out of the 779 patients 21.7% experienced side effects. The most common side effects were constipation (6.8%) and dry mouth/lips (6.0%) and 3.5% of patients ceased solifenacin due to adverse effects. Overall, the certainty of the evidence for side effects and tolerability were very low. DISCUSSION The reported incidence of side effects is low, and less than reported with oxybutynin use. However, the very low certainty of the evidence means the findings should be interpreted with caution. There is limited reporting of a prolonged QTc interval on ECG. Studies that described this only had an increase of QTc from baseline and not a clinically significant prolonged QTc that resulted in arrhythmias. CONCLUSION Solifenacin is an alternative anticholinergic for the treatment of OAB in children. However, given the paucity of good quality data on safety and tolerability it should be used cautiously in children with close monitoring for potential side effects.
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Affiliation(s)
- Gayathri Raman
- Department of Nephrology, Children's Hospital at Westmead, Hawkesbury Road, Westmead NSW 2045 Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Australia; Discipline of Child and Adolescent Health, University of Sydney, Australia.
| | - David Tunnicliffe
- Sydney School of Public Health, University of Sydney, Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Australia.
| | - Elise Lai
- Department of Nephrology, Children's Hospital at Westmead, Hawkesbury Road, Westmead NSW 2045 Australia.
| | | | - Patrina Caldwell
- Department of Nephrology, Children's Hospital at Westmead, Hawkesbury Road, Westmead NSW 2045 Australia; Centre for Kidney Research, The Children's Hospital at Westmead, Australia; Discipline of Child and Adolescent Health, University of Sydney, Australia.
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Ito K, Izumi N, Funayama S, Nohno K, Katsura K, Kaneko N, Inoue M. Characteristics of medication-induced xerostomia and effect of treatment. PLoS One 2023; 18:e0280224. [PMID: 36634078 PMCID: PMC9836311 DOI: 10.1371/journal.pone.0280224] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 12/26/2022] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE Side-effects of medications cause xerostomia. There have been cases where a medication has been discontinued owing to its severe side-effects. Therefore, the xerostomia must be treated to ensure that the primary disease is managed effectively. This study analyzed the actual status of patients with medication-induced xerostomia and investigates factors associated with its improvement. METHODS This study assessed 490 patients diagnosed with medication-induced xerostomia who had an unstimulated salivary flow of ≤0.1 mL/min and received treatment for xerostomia at a xerostomia clinic. Patient age, sex, medical history, medications used, disease duration of xerostomia, and psychological disorders were recorded. The anticholinergic burden was assessed using the Anticholinergic Cognitive Burden scale. The unstimulated salivary flow was measured by the spitting method. According to their symptoms and diagnoses, the patients were introduced to oral lubricants, instructed on how to perform massage, and prescribed Japanese herbal medicines, and sialogogues. Factors associated with the subjective improvement of xerostomia and objective changes in the salivary flow rate were recorded at six months. RESULTS Xerostomia improved in 338 patients (75.3%). The improvement rate was significantly lower in patients with psychiatric disorders (63.6%) (P = 0.009). The improvement rate decreased as more anticholinergics were used (P = 0.018). However, xerostomia improved in approximately 60% of patients receiving three or more anticholinergics. The unstimulated salivary flow increased significantly more in patients who reported an improvement of xerostomia (0.033±0.053 mL/min) than in those who reported no improvement (0.013±0.02 mL/min) (P = 0.025). CONCLUSION Xerostomia treatment improved oral dryness in 75.3% of patients receiving xerogenic medications in this study. If xerostomia due to side-effects of medications can be improved by treatment, it will greatly contribute to the quality of life of patients with xerogenic medications and may reduce the number of patients who discontinue medications.
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Affiliation(s)
- Kayoko Ito
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
- * E-mail:
| | - Naoko Izumi
- Medical Affairs, Internal Medicine, Pfizer Japan, Inc., Tokyo, Japan
| | - Saori Funayama
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kaname Nohno
- Division of Oral Science for Health Promotion, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kouji Katsura
- Department of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Noboru Kaneko
- Division of Preventive Dentistry, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Makoto Inoue
- Oral Rehabilitation, Niigata University Medical and Dental Hospital, Niigata, Japan
- Division of Dysphagia Rehabilitation, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Du C, Berg W, Siegal AR, Huang Z, Jeong R, Hwang K, Kim J. Real-world Compliance With Percutaneous Tibial Nerve Stimulation Maintenance Therapy in an American Population. Urology 2021; 153:119-123. [PMID: 33581232 DOI: 10.1016/j.urology.2021.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/27/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate percutaneous tibial nerve stimulation (PTNS) maintenance therapy dropout rates and identify factors associated with compliance in an American population. METHODS We retrospectively queried our PTNS database for patients from 2014-2019. Demographic, relevant clinical, and visit data were collected. Maintenance therapy was patient-driven and frequency of sessions was tapered based on symptomology. Upon completion of 12 initial sessions, we assessed dropout from maintenance at 3, 6, 9, and 12 months. Multiple variables were tested for correlation with dropout in patients continuing maintenance therapy for 1 year vs those who dropped out. RESULTS One hundred and sixty-three PTNS patients were identified, of which 104 completed initial therapy and 81 proceeded with maintenance therapy. At 3, 6, 9, and 12 months, maintenance continuation rates were 77.8% (63/81), 58.0% (47/81), 45.6% (37/81), and 39.5% (32/41), respectively. Primary reasons for dropout were worsening of urinary symptoms/lack of efficacy (n = 21), time commitment (n = 9), loss of insurance (n = 5), medical comorbidities (n = 4), request for alternative OAB treatment (n = 2), and unknown (n = 8). On both univariate and multivariate analysis, perceived symptom improvement (P<.01; HR = 0.02, P< .01) was associated with continuing maintenance therapy. On only univariate analysis, neurological history (P = .02) and multiple sclerosis history (0.02) were associated with continuing therapy. CONCLUSION Only 39.5% of patients continue to undergo maintenance PTNS therapy after 1 year. Future studies are required to understand and ameliorate factors for low compliance in PTNS maintenance therapy.
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Affiliation(s)
- Chris Du
- Stony Brook Medicine, Department of Urology.
| | | | | | | | - Rosen Jeong
- Stony Brook University, Renaissance School of Medicine
| | - Kuemin Hwang
- Stony Brook University, Renaissance School of Medicine
| | - Jason Kim
- Stony Brook Medicine, Department of Urology
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Ahn ST, Lee DH, Jeong HG, Kim JW, Oh MM, Park HS, Moon DG. Treatment persistence with a fixed-dose combination of tadalafil (5 mg) and tamsulosin (0.4 mg) and reasons for early discontinuation in patients with benign prostatic hyperplasia and erectile dysfunction. Investig Clin Urol 2020; 61:81-87. [PMID: 31942467 PMCID: PMC6946826 DOI: 10.4111/icu.2020.61.1.81] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 08/06/2019] [Indexed: 01/23/2023] Open
Abstract
Purpose The primary aim of this study was to assess treatment persistence with a fixed-dose combination (FDC) of tadalafil (5 mg) and tamsulosin (0.4 mg). This study also evaluated the reasons for early treatment discontinuation. Materials and Methods This retrospective observational study included patients with benign prostatic hyperplasia and erectile dysfunction who started an FDC treatment of tadalafil (5 mg) and tamsulosin (0.4 mg) between July 2017 and February 2018. Treatment persistence and reasons for early discontinuation were evaluated during the first 6 months. The cumulative discontinuation rate and differences in various parameters were assessed using Kaplan–Meier analysis and the log-rank test, respectively. Factors related to persistence were analyzed using a Cox proportional hazard model. Results Overall, 97 patients were included in the study. The cumulative persistence rate at 30, 90, and 180 days was 88.7%, 66.0%, and 54.6%, respectively. The cumulative persistence over 6 months differed significantly according to the administration of FDC therapy (log-rank p=0.005) and age (log-rank p=0.024). Younger patients (odds ratio, 2.049; p=0.021) and treatment-naive patients (odds ratio, 2.461; p=0.006) were more likely to discontinue therapy within 6 months. The common reasons for discontinuing therapy were side effects (63.6%) and perceived poor efficacy (22.7%). Conclusions Side effects were reported to be the main reason for treatment discontinuation. Thus, to improve compliance for a once-daily FDC of tadalafil (5 mg) and tamsulosin (0.4 mg), it is recommended to select patients who show adaptation to a combination of α-blockers and phosphodiesterase type 5 inhibitors prior to FDC treatment.
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Affiliation(s)
- Sun Tae Ahn
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Dong Hyun Lee
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Hyeong Guk Jeong
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Jong Wook Kim
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Mi Mi Oh
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Hong Seok Park
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
| | - Du Geon Moon
- Department of Urology, Korea University Guro Hospital, Seoul, Korea
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Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients. J Formos Med Assoc 2019; 118:279-284. [DOI: 10.1016/j.jfma.2018.05.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/31/2017] [Accepted: 05/07/2018] [Indexed: 11/19/2022] Open
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Goodson AB, Cantrell MA, Shaw RF, Lund BC. Comparative Effectiveness of Anticholinergic Agents for Lower Urinary Tract Symptoms. J Manag Care Spec Pharm 2018; 24:65-72. [PMID: 29290176 PMCID: PMC10397834 DOI: 10.18553/jmcp.2018.24.1.65] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Limited data from short-term clinical trials suggest efficacy advantages of solifenacin and fesoterodine over other anticholinergic agents in the treatment of lower urinary tract symptoms. OBJECTIVES To (a) determine the real-world comparative effectiveness of newer anticholinergic agents for lower urinary tract symptoms, as assessed by 1-year persistence, and (b) identify patient factors independently associated with persistence. METHODS We conducted a retrospective cohort study of U.S. veterans initiating newer anticholinergic therapy between October 2007 and August 2015. Multiple log-binomial regression was used to contrast 1-year persistence rates across anticholinergic agents while adjusting for measured confounders. Persistence was selected as a measure of effectiveness because nonpersistence is a common pathway encompassing inefficacy and intolerability, particularly in symptom-driven conditions. RESULTS A total of 26,775 patients were included, of which 10,386 (38.8%) persisted with anticholinergic therapy at 1 year. Using long-acting tolterodine as the reference agent, superior persistence rates were observed for solifenacin (RR = 1.08, 95% CI = 1.03-1.13) and fesoterodine (RR = 1.25, 95% CI = 1.09-1.43), and a lower rate for short-acting tolterodine (RR = 0.90, 95% CI = 0.85-0.94). Patient factors associated with higher persistence rates included older age, male sex, and comorbidities such as multiple sclerosis, Parkinson's disease, and diabetes. CONCLUSIONS Consistent with clinical trial reports, we found evidence for superior effectiveness of solifenacin and fesoterodine relative to other anti-cholinergics and for long-acting formulations over short-acting formulations. DISCLOSURES This work was supported by the Iowa City VA Health Care System and by the Department of Veterans Affairs, Office of Research and Development, Health Services Research and Development Service (CDA 10-017). The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the U.S. government. The authors have no conflicts of interest. Study concept and design were contributed by all the authors. Shaw took the lead in data collection, along with Lund, and data interpretation was performed by Lund, Goodson, and Cantrell. The manuscript was written by Goodson, Cantrell, Lund, and Shaw and revised by Lund, Goodson, Cantrell, and Shaw.
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Affiliation(s)
- Ali B Goodson
- 1 Department of Pharmacy Services, Iowa City VA Health Care System, Iowa City, Iowa
| | - Matthew A Cantrell
- 1 Department of Pharmacy Services, Iowa City VA Health Care System, Iowa City, Iowa
| | - Robert F Shaw
- 1 Department of Pharmacy Services, Iowa City VA Health Care System, Iowa City, Iowa
| | - Brian C Lund
- 2 Center for Comprehensive Access & Delivery Research and Evaluation and Department of Pharmacy Services, Iowa City VA Health Care System, Iowa City, Iowa
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Crespo C, Blasco P, Guigini M, Galván J. Clinical and Economic Evaluation of Transdermal Oxybutynin in the Treatment of Overactive Bladder in Spain. JOURNAL OF HEALTH ECONOMICS AND OUTCOMES RESEARCH 2018; 5:194-205. [PMID: 35620774 PMCID: PMC9090463 DOI: 10.36469/9811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Background: This study evaluated the clinical outcomes and economic results of transdermal oxybutynin compared to fesoterodine, tolterodine, solifenacin, oxybutynin, trospium chloride, and mirabegron for overactive bladder syndrome in Spain. Materials and Methods: A Markov model was built with monthly cycles for a 5-year time frame. The model reflected clinical events, discontinuation, dose scaling and change in treatment according to actual clinical practice. Based on experts' opinion and the literature, the use of resources and Spanish costs were incorporated into the model. The measure of efficiency used was the cost per quality-adjusted life year (QALY) gained. The economic evaluation was performed from the perspective of the Spanish healthcare system, discounting costs (€2017) and effects at 3%. The robustness of the results was validated with a deterministic and probabilistic sensitivity analysis. Results: After a year, transdermal oxybutynin was seen to have greater persistence deriving from its better risk/benefit balance compared to muscarinic antagonists and mirabegron (55% transdermal oxybutynin, 33% mirabegron, 25% tolterodine, 27% fesoterodine, 25% solifenacin, 23% trospium chloride and 17% oxybutynin). At 5-years, better persistence resulted in improvements in QALY gained by transdermal oxybutynin of 0.050, 0.040, 0.039, 0.038, 0.034 and 0.010 compared to oxybutynin, fesoterodine, solifenacin, trospium chloride, tolterodine and mirabegron, respectively. The incremental cost-effectiveness ratio of transdermal oxybutynin ranged from €1313.96 per QALY gained compared to fesoterodine to €14 101.57 per QALY gained compared to trospium chloride. Conclusions: Kentera® (transdermal oxybutynin) is a cost-effective treatment in overactive bladder syndrome compared to muscarinic antagonists and mirabegron.
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Affiliation(s)
- Carlos Crespo
- GM Department of Statistics, Universita de Barcelona, Barcelona, Spain; Axentiva Solutions, Sta. Cruz de Tenerife, Spain
| | - Pedro Blasco
- Department of Urology, Hospital Universitario de Valme, Seville, Spain
| | - Marcelo Guigini
- Medical and Regulatory Affairs Department, Laboratorios Gebro Pharma S.A., Barcelona , Spain
| | - Jordi Galván
- Medical and Regulatory Affairs Department, Laboratorios Gebro Pharma S.A., Barcelona , Spain
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Juan YS, Chen HW, Chen YC, Wu WJ, Li CC, Chang YH, Geng JH, Shen JT, Jang MY, Yang KF. Comparative persistence, switch rates, and predictors for discontinuation of antimuscarinics for overactive bladder: A 10-year nationwide population-based study in Taiwan. UROLOGICAL SCIENCE 2018. [DOI: 10.4103/uros.uros_2_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Description de la typologie de patients masculins répondeurs aux anticholinergiques : une étude observationnelle. Prog Urol 2017; 27:551-558. [DOI: 10.1016/j.purol.2017.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Revised: 05/11/2017] [Accepted: 06/02/2017] [Indexed: 11/21/2022]
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Herschorn S, Kohan A, Aliotta P, McCammon K, Sriram R, Abrams S, Lam W, Everaert K. The Efficacy and Safety of OnabotulinumtoxinA or Solifenacin Compared with Placebo in Solifenacin Naïve Patients with Refractory Overactive Bladder: Results from a Multicenter, Randomized, Double-Blind Phase 3b Trial. J Urol 2017; 198:167-175. [DOI: 10.1016/j.juro.2017.01.069] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2017] [Indexed: 11/25/2022]
Affiliation(s)
| | - Alfred Kohan
- Advanced Urology Centers of New York, Bethpage, New York
| | - Philip Aliotta
- Western New York Urology Associates, Williamsville, New York
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Kim TH, Lee KS. Persistence and compliance with medication management in the treatment of overactive bladder. Investig Clin Urol 2016; 57:84-93. [PMID: 26981589 PMCID: PMC4791665 DOI: 10.4111/icu.2016.57.2.84] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 03/04/2016] [Indexed: 01/31/2023] Open
Abstract
Overactive bladder (OAB) is a common and chronic condition that impacts patients' daily activities and quality of life. Pharmaco-therapy for OAB is a mainstay of treatment. Antimuscarinics and β3-adrenoceptor agonists are the two major classes of oral pharmacotherapy and have similar efficacy for treating the symptoms of OAB. Owing to the chronic nature of OAB, long-term use of medication is essential for OAB symptom control and positive health outcomes. However, many patients elect to stop their medications during the treatment period. Unmet expectations of treatment and side effects seem to be the major factors for discontinuing OAB pharmacotherapy. Furthermore, the short- and long-term persistence and compliance with medication management are markedly worse in OAB than in other chronic medical conditions. Improvement in persistence and compliance with OAB pharmacotherapy is a hot topic in OAB treatment and should be an important goal in the treatment of OAB. Effective strategies should be identified to improve persistence and compliance. In this review, we outline what is known about persistence and compliance and the factors affecting persistence with pharmacotherapy in patients with OAB.
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Affiliation(s)
- Tae Heon Kim
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyu-Sung Lee
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.; Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Korea
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