Long-Term Patterns of Use and Treatment Failure With Anticholinergic Agents for Overactive Bladder

Chancellor, Michael B.; Migliaccio–Walle, Kristen; Bramley, Thomas; Chaudhari, Sham; Corbell, Catherine; Globe, Denise

doi:10.1016/j.clinthera.2013.08.017

Cited by 110 publications

(111 citation statements)

References 13 publications

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“…In recent years, a number of papers have been published looking at discontinuation rates over a prolonged period. 4,8,11,13 These papers report discontinuation rates at one year between 51.7 and 88%. Our data demonstrate no difference in discontinuation between oxybutynin and solifenacin and increased discontinuation for patients taking tolterodine or darifenacin; however, factors beyond clinical efficacy and tolerability may explain these results.…”

Section: Discussionmentioning

confidence: 99%

Anticholinergics for overactive bladder: Temporal trends in prescription and treatment persistence

Wallis

Lundeen²,

Golda³

et al. 2016

CUAJ

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Introduction: We sought to understand the contemporary pharmacologic management of overactive bladder (OAB) in a single-payer system. We examined temporal trends in the use of anticholinergic medications and assessed whether the likelihood of patients changing their anticholinergic therapy was predicted by their current therapy. Methods: We conducted a retrospective, population-based analysis of prescription records from the PharmaNet database in BC, Canada. We identified patients treated with one or more anticholinergic prescriptions between 2001 and 2009. We characterized temporal trends in the use of anticholinergic medications. We used generalized estimating equations with a logit wing to assess the relationship between the type of anticholinergic medication and the change in prescription. Results: The 114 325 included patients filled 1 140 296 anticholinergic prescriptions. The number of prescriptions each year increased over the study, both in aggregate and for each individual medication. While oxybutynin was the most commonly prescribed medication (68% of all prescriptions), the proportion of newer anticholinergics (solifenacin, darifenacin, and trospium) prescribed increased over time (p<0.0001). Patients taking tolterodine (odds ratio [OR] 1.03; p=0.01) and darifenacin (OR 1.12; p=0.0006) were significantly more likely to change their prescription than those taking oxybutynin. There was no association seen for patients taking solifenacin (p=0.6) and trospium (p=0.9). Conclusions: There are an increasing number of anticholinergic prescriptions being filled annually. Patients taking newer anticholinergics are at least as likely to change therapy as those taking oxybutynin. The reimbursement environment in BC likely affects these results. Restrictions in the available data limit assessment of other relevant predictors.

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Section: Discussionmentioning

confidence: 99%

Anticholinergics for overactive bladder: Temporal trends in prescription and treatment persistence

Wallis

Lundeen²,

Golda³

et al. 2016

CUAJ

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“…11 A further 34.6% tend to stop and later reinitiate treatment, while 5.8% switch to a second-line drug. Of those who switch therapy, 81% have been shown to discontinue a second-line drug.…”

Section: What Happens To Patients Who Discontinue Therapy?mentioning

confidence: 99%

Managing overactive bladder in primary care

Robinson¹,

Belal²,

Granitsiotis³

et al. 2017

Trends Urol & Men's Health

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O veractive bladder (OAB) is the term used to describe the symptom complex of urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence, in the absence of urinary tract infection or other obvious pathology. 1 HOW COMMON IS OAB?Epidemiological studies from North America have reported a prevalence of OAB in women of 16.9%, increasing with age to 30.9% in those over the age of 65 years. 2 Further data from Europe have shown the overall prevalence in men and women over the age of 40 years to be 16.6%. 3 Frequency was the most commonly reported symptom (85%), while 54% complained of urgency and 36% of urgency incontinence. The European Prospective Investigation into Cancer and Nutrition (EPIC) study, a cross-sectional telephone survey conducted in Canada and four European countries including the UK, utilised the International Continence Society terminology (more specific for the current OAB definition) and found the prevalence of OAB to be 12.8% in women and 10.8% in men.

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“…Agents that block muscarinic receptors, which act by inhibiting neuromuscular transmission to the urinary bladder by blocking postjunctional muscarinic receptors in the detrusor muscle, are the first line of therapeutic agents prescribed for OAB treatment. However, up to 75% of patients treated with antimuscarinic drugs discontinue their use, either due to poor tolerance of their side effects or because of a lack of efficacy (Kelleher et al, 1997;Chapple, 2000;Chancellor et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

A1 Adenosine Receptor-Mediated Inhibition of Parasympathetic Neuromuscular Transmission in Human and Murine Urinary Bladder

Searl

Dynda

Alanee

et al. 2015

Journal of Pharmacology and Experimental Therapeutics

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The potential role of A 1 adenosine receptors in modulating neuromuscular transmission in the detrusor muscle of the urinary bladder has been tested in human and murine preparations with the intent to determine the viability of using adenosine receptor agonists as adjuncts to treat overactive bladder. In human detrusor muscle preparations, contractile responses to electrical field stimulation were inhibited by the selective A 1 adenosine receptor agonists 2-chloro-N the effects of CPA, thus confirming the role of A 1 receptors in human detrusor preparations. In murine detrusor muscle preparations, contractions evoked by electrical field stimulation were reduced by CPA or adenosine. Amplitudes of the P2X purinoceptor-mediated excitatory junctional potentials (EJPs) recorded with intracellular microelectrodes were reduced in amplitude by CPA and adenosine with no effect on the spontaneous EJP amplitudes, confirming the prejunctional action of these agents. 8-Cyclopentyltheophylline, a selective A 1 receptor antagonist, reversed the effects of CPA on EJP amplitudes with no effect of spontaneous EJPs, confirming the role of A 1 receptors in mediating these effects.

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Long-Term Patterns of Use and Treatment Failure With Anticholinergic Agents for Overactive Bladder

Cited by 110 publications

References 13 publications

Anticholinergics for overactive bladder: Temporal trends in prescription and treatment persistence

Anticholinergics for overactive bladder: Temporal trends in prescription and treatment persistence

Managing overactive bladder in primary care

A1 Adenosine Receptor-Mediated Inhibition of Parasympathetic Neuromuscular Transmission in Human and Murine Urinary Bladder

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