Which drugs are best for overactive bladder? From patients’ expectations to physicians’ decisions

Abstract

Aim In order to help physicians determine which drugs are the best for treating overactive bladder (OAB) symptoms, this review considered three questions: what are the patient's expectations? What information is generated by the Multicriteria Decision Analysis (MCDA) model? What can physicians expect from medical treatments? Methods A comprehensive literature search was undertaken on these three topics in order to assist physicians regarding the optimum treatment modality for OAB. Results Patients’ difficulties in reporting symptoms and their expectations of treatment outcomes interfere with the success of treatment. To assist physicians in meeting patients’ expectations and to choose the most appropriate treatment, a new approach, recognised by the European Medicines Agency, the MCDA model was used to compare the benefits and safety of OAB treatments. Conclusion The MCDA model is useful for comparing the benefit‐safety profiles of OAB drugs in order to equip clinicians with information on the drug that might best meet their patient's needs. Flexibly dosed fesoterodine appeared to be most efficacious in resolving urgency and urgency incontinence compared with other drugs, and resolution of urinary urgency appears to be associated with a reduced number of reported adverse events.

Anticholinergic therapy of an overactive bladder: clinical practice aspects

“…I. Milsom et al [48] отметили, что профили эффективности и безопасности лекарственных препаратов для лечения ГМП различаются, но в клинических исследованиях число прямых сравнений невелико. Результаты метаанализов и систематических обзоров позволяют проводить сравнение различных фармпрепаратов по определенным, заранее заданным критериям, однако в них не учитывается важность и клиническая значимость эффектов с точки зрения пользы и безопасности.…”

“…Результаты метаанализов и систематических обзоров позволяют проводить сравнение различных фармпрепаратов по определенным, заранее заданным критериям, однако в них не учитывается важность и клиническая значимость эффектов с точки зрения пользы и безопасности. Это обстоятельство, по мнению авторов, при назначении медикаментозного лечения ГМП выводит на первый план именно результаты МКАПР [48].…”

Assessing Effectiveness of ‘Onabotulinumtoxin A’ (Botox®) Intradetrusor Injection for Overactive Bladder Patients after Endoscopic Interventions for Benign Prostatic Hyperplasia

“…[39][40][41][42] Fesoterodine was considered the best anticholinergic by a 2021 multicriteria decision analysis model and better than the β3 adrenoceptor agonist mirabegron and solife-nacin/mirabegron drug combinations. 43 Propiverine has shown to increase bladder capacity and compliance, combining anticholinergic and calcium channel blocking actions. [44][45][46] Imipramine and other tricyclic antidepressants can be used for their anticholinergic activities and capacity to decrease bladder contractility.…”