Individualizing medical treatment of overactive bladder

Kuo, Hann‐Chorng

doi:10.4103/tcmj.tcmj_83_18

Cited by 4 publications

(4 citation statements)

References 46 publications

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“…Further, these AEs lead to low adherence rates 18 . A new OAB drug is necessary so that physicians can adjust the dose and combine it with different medications to achieve the best efficacy and reduce AEs to the minimum possible 24 …”

Section: Discussionmentioning

confidence: 99%

A double‐blind, randomized, placebo‐controlled, parallel study to evaluate the efficacy and safety of imidafenacin in patients with overactive bladder in Taiwan

Chuang

Lin

Chow

et al. 2020

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Objective: This study evaluated the efficacy and safety of imidafenacin 0.1 mg twice daily vs placebo for Taiwanese patients with overactive bladder (OAB) after a 12-week oral administration. Methods: This randomized, double-blind, placebo-controlled, two-arm, parallelgroup, prospective study enrolled 118 patients across 11 study sites in Taiwan. Subjects were randomized to imidafenacin or placebo in a 2:1 ratio and entered the 12-week treatment period. At the subsequent visits, efficacy outcome measures and safety assessments were collected for analysis. The primary efficacy outcome was the change in the mean number of micturitions per day. Secondary endpoints included mean changes from baseline in urgency episodes and urge incontinence episodes per day and mean volume voided per micturition. Safety outcomes were also collected and compared between groups. Results: A total of 78 and 40 patients were allocated to the imidafenacin and placebo groups, respectively. Among them, 100 patients (imidafenacin, 65 and placebo, 35) completed the trial. Compared with placebo, imidafenacin was significantly better at reducing the number of micturitions per day (−1.29 ± 2.23 vs-0.46 ± 3.49, P = .0171) and reducing the mean number of urge incontinence episodes (−0.15 ± 0.52 vs 0.04 ± 0.50, P = .0386) at week 12. Adverse events were reported in 35 subjects (44.9%) and 16 (40%) in the imidafenacin and placebo groups, including constipation (n = 3, 4), dry mouth (n = 11, 2), and urinary tract infection (n = 7, 4), respectively. One patient in the imidafenacin group had mild dysuria. Conclusion: Imidafenacin demonstrated efficacy and safety in the treatment of OAB in Taiwanese patients.

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Section: Discussionmentioning

confidence: 99%

A double‐blind, randomized, placebo‐controlled, parallel study to evaluate the efficacy and safety of imidafenacin in patients with overactive bladder in Taiwan

Chuang

Lin

Chow

et al. 2020

LUTS

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“…[26][27][28] Kuo et al recommend individualized treatment of overactive bladder syndrome patients. 29 In the famous SYMPHONY trial, Abrams et al observed that Mirabegron in combination with Solifenacin or Darifenacin gave better results in treatment of OAB than either drug alone. 30…”

Section: Discussionmentioning

confidence: 99%

Correlation of incontinence impact questionnaire score in overactive bladder syndrome cases with urodynamic findings

Sharma

Chauhan

Bhatla

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Background: Overactive bladder syndrome (OAB) is a common condition. The aim of the present study was to correlate the incontinence impact questionnaire (IIQ) score with urodynamic studies in patients of overactive bladder syndrome.Methods: It was a prospective study performed in a tertiary referral centre on 60 women with symptomatology of OAB. IIQ score was calculated and urodynamic studies were performed in all patients in which detrusor overactivity, maximum flow rate of urine per second (Qmax) and voiding time in seconds was calculated in all women.Results: The mean age was 42.3±9.91 years, mean body mass index was 24.7±2.71 kg/m2, mean parity was 2.4 and mean serum creatinine level was 0.84±0.21 mg/dl. Symptoms seen were urgency (100%), frequency (100%), urge incontinence (95.0%) and nocturia (76.6%). IIQ score ranged from 7-20 with mean being 12.27±3.38. OAB was mild in 36.6%, moderate in 41.66% and severe in 21.66% patients. On urodynamic studies, detrusor overactivity was present in 75% cases being 59% in mild, 80% in moderate and 76.92% in severe OAB. Mean Qmax increased with severity of OAB and was 29.55ml/second in mild OAB, 30.36ml/second in moderate OAB and 31.59 ml/second in severe OAB. Mean voiding time decreased with severity of OAB and was 33.44 seconds in mild OAB, 32.14 seconds in moderate OAB and 31.47 seconds in severe OAB.Conclusions: IIQ score and urodynamic studies are useful in diagnosis and quantification of OAB syndrome.

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“…OAB is highly prevalent and has an impact on patient quality of life. The current oral medications for OAB include antimuscarinics and beta-3 adrenoceptor agonists [6]. In patients refractory to these OAB medications, intravesical Botox injection has been documented to act as a third-line treatment according to the American Urological Association (AUA) and European Association of Urology guidelines [31,32].…”

Section: Botox Injection For Oabmentioning

confidence: 99%

“…OnabotulinumtoxinA (BOTOX ® ; Allergan, Irvine, CA, USA) was first used to treat patients with spinal cord injury having neurogenic detrusor overactivity (NDO) or detrusorsphincter dyssynergia [1][2][3][4]. Later, Botox was used for the treatment of idiopathic detrusor overactivity (IDO) and overactive bladder syndrome (OAB) refractory to conventional treatment [5][6][7]. Botox has been approved for these two clinical conditions, and it has been widely used to restore urinary continence and improve quality of life [8,9].…”

Section: Introductionmentioning

confidence: 99%

Clinical application of intravesical botulinum toxin type A for overactive bladder and interstitial cystitis

Chen

Kuo

2020

Investig Clin Urol

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After decades of clinical and basic science research, the clinical application of botulinum toxin A (Botox) in urology has been extended to neurogenic detrusor overactivity (NDO), idiopathic detrusor overactivity, refractory overactive bladder (OAB), interstitial cystitis/bladder pain syndrome (IC/BPS), lower urinary tract symptoms, benign prostatic hyperplasia, and neurogenic or non-neurogenic lower urinary tract dysfunction in children. Botox selectively disrupts and modulates neurotransmission, suppresses detrusor overactivity, and modulates sensory function, inflammation, and glandular function. In addition to motor effects, Botox has been found to have sensory inhibitory effects and anti-inflammatory effects; therefore, it has been used to treat IC/BPS and OAB. Currently, Botox has been approved for the treatment of NDO and OAB. Recent clinical trials on Botox for the treatment of IC/BPS have reported promising therapeutic effects, including reduced bladder pain. Additionally, the therapeutic duration was found to be longer with repeated Botox injections than with a single injection. However, the use of Botox for IC/BPS has not been approved. This paper reviews the recent advances in intravesical Botox treatment for OAB and IC/BPS.

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Individualizing medical treatment of overactive bladder

Cited by 4 publications

References 46 publications

A double‐blind, randomized, placebo‐controlled, parallel study to evaluate the efficacy and safety of imidafenacin in patients with overactive bladder in Taiwan

A double‐blind, randomized, placebo‐controlled, parallel study to evaluate the efficacy and safety of imidafenacin in patients with overactive bladder in Taiwan

Correlation of incontinence impact questionnaire score in overactive bladder syndrome cases with urodynamic findings

Clinical application of intravesical botulinum toxin type A for overactive bladder and interstitial cystitis

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