Factors associated with a better therapeutic effect of solifenacin in patients with overactive bladder syndrome

Abstract

To analyze the predictors of therapeutic success after solifenacin treatment. Between January 2008 and December 2011, all patients with overactive bladder syndrome (OAB) who consecutively visited the urologic outpatient clinics of a medical center were prospectively enrolled. All enrolled patients received 5 mg solifenacin once a day for 12 weeks. Overall, 648 patients, 332 men, and 316 women, completed the 12-week study. The overall success rate was 48.8%. The success rate for female patients was superior to that for male patients (55.4% vs. 42.5%, P < .001). The urgency severity scale (USS) score, daytime frequency, nocturia, voided volume, and bladder capacity were all improved after 12 weeks' treatment. Multivariate logistic regression analysis revealed that female gender, high USS score, high maximum flow rate (Qmax ), and low postvoid residual volume (PVR) were all significant predictive factors for success after antimuscarinic treatment. USS score = 4 and Qmax ≥ 12 ml/sec were the most strongly predictive cutoff values for success, with receiver operating characteristic curve (ROC) areas of 0.70 (sensitivity = 66.8%, specificity = 66.0%) and 0.63 (sensitivity = 80.7%, specificity = 43.1%), respectively. PVR ≥ 70 ml was the most predictive cutoff value for failure, with a ROC area of 0.58 (sensitivity = 18.2%, specificity = 93.7%). Female gender, high USS score, high Qmax , and low PVR were associated with better therapeutic efficacy. These findings could serve as an initial guide or assist in consultation regarding the treatment of OAB patients with antimuscarinics.