Predictive factors of repeat therapy in overactive bladder patients
Frequent nocturia episodes, a suboptimal response, and small bladder capacity appear to predict the need for persistent antimuscarinic therapy or re-treatment after solifenacin treatment in women with overactive bladder syndrome, according to a study.
Researchers enrolled 107 women who received treatment with solifenacin for 12 weeks. Cox regression model was used to analyse factors affecting re-treatment. The median follow-up was 20.4 weeks.
Of the women, 25 required re-treatment. The median re-treatment-free interval was 125.4 weeks.
On Cox regression analysis, the independent predictors of re-treatment were nocturia episodes (hazard ratio [HR], 1.54), a suboptimal response (HR, 2.53), and the strong-desire volume (HR, 0.992). The corresponding areas under the receiver-operating characteristic curves were only 0.65, 0.63, and 0.59.
Normalised urinary nerve growth factor level showed no significant association with re-treatment (HR, 1.005; p=0.68).
Moreover, normalised urodynamic findings did not correlate with need for re-treatment, a suboptimal response, or changes of Overactive Bladder Symptom Score and urinary nerve growth factor level.
The findings may serve as an initial guide in consultation regarding the treatment of overactive bladder, researchers said.
Overactive bladder is a bothersome condition that can negatively affect health-related quality of life. Behavioural and pharmacologic therapies are available as treatment options, with antimuscarinics being used as a first-line pharmacologic therapy. [Urol Nurs 2012;32:38-46]