Abstract
Background: Overactive bladder (OAB) syndrome is defined as urinary urgency, with or without urge incontinence in the absence of an underlying pathological or metabolic cause. Treatment for OAB involves anti-muscarinic agents and beta 3-adrenoceptor agonists. As a previous study showed that treatment may increase the risk of urinary tract infection (UTI), we conducted a nationwide, population-based, retrospective study to assess UTI risk associated with OAB medication adherence, and different types of OAB medication. Methods: The source of data was medical records from National Health Insurance Research Database (NHIRD). Patients who were diagnosed with OAB in outpatient records from January 1, 2014 to December 31, 2016 were included. Outpatient visits included an attendance at primary care or the emergency department. The index date was the first prescription medication for OAB treatment after diagnosis. The targeted population was those diagnosed with OAB, and targeted drugs were anti-muscarinic agent (including flavoxate, oxybutynin, propiverine, solifenacin, tolterodine, and trospium) and mirabegron. Adherence was assessed based on the proportion of days covered in 12 months among mirabegron and anti-muscarinic agents. A multivariate Cox proportional-hazards model was used to compare the risk of UTI with OAB medication adherence, and different types of OAB medication. Results: There were 39,975 outpatients diagnosed with OAB in the database from 2014 to 2016. Excluding those younger than 20 years old and for whom the information was incomplete in the database, 21,869 patients were included in the final OAB cohort. Overall, risk of UTI was not influenced by the targeted drugs or adherence during the follow-up period, regardless of UTI history or sex. Conclusion: OAB is a common problem in Taiwan. After 12 months of follow-up, there was no difference between anticholinergic medications and beta-3 agonists, nor between high and low adherence in the risk of UTI.
Highlights
Overactive bladder (OAB) syndrome is defined by the International Continence Society (ICS) as urgency, with or without urge incontinence, usually with increased daytime frequency and nocturia in the absence of pathologic or metabolic factors that would explain these symptoms (NikAhd et al, 2018)
The aim of our study was to examine the hazard of urinary tract infection (UTI) with OAB medication adherence and comparing risk of UTI between anti-muscarinic agents and beta 3-adrenoceptor agonists
After excluding those aged younger than 20 years old and for whom information was incomplete in the database, 38,538 patients were included in the OAB cohort
Summary
Overactive bladder (OAB) syndrome is defined by the International Continence Society (ICS) as urgency, with or without urge incontinence, usually with increased daytime frequency and nocturia in the absence of pathologic or metabolic factors that would explain these symptoms (NikAhd et al, 2018). OAB is high in prevalence and commonly affects patients over the age of 40. Second-line treatments are medication and include anti-muscarinic agents and beta 3-adrenergic receptor agonist. Overactive bladder (OAB) syndrome is defined as urinary urgency, with or without urge incontinence in the absence of an underlying pathological or metabolic cause. Treatment for OAB involves anti-muscarinic agents and beta 3-adrenoceptor agonists. As a previous study showed that treatment may increase the risk of urinary tract infection (UTI), we conducted a nationwide, population-based, retrospective study to assess UTI risk associated with OAB medication adherence, and different types of OAB medication
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