Solifenacin Treatment Research Articles

Social, Economic, and Medical Factors Associated With Solifenacin Therapy Compliance Among Workers Who Suffer From Lower Urinary Tract Symptoms.

PurposeThe prevalence of hyperactive-type lower urinary tract symptoms is 45.2%, with shares of overactive bladder (OAB) and urge incontinence (UI) symptoms of 10.7% and 8.2%, respectively. We investigated the possible impact of a wide range of social, economic, and medical factors on compliance with solifenacin treatment in the working population.MethodsSocial, economic, and medical factors as well as the Overactive Bladder questionnaire – the OAB-q Short Form (OAB-q SF), bladder diaries, and uroflowmetry of 1,038 people who were administered solifenacin for a year were gathered from employer documentation.ResultsAmong the subjects, 32% maintained their compliance with solifenacin treatment throughout the year. Only 65% of the patients had compliance exceeding 80%, and 17% of patients had compliance of ≥50%, yet less than 80% were still taking solifenacin 12 months after the beginning of this experiment. Working people whose compliance level was, at least, 80% had reliably higher (P≤0.01) average age, annual salary, and treatment efficacy, and a greater treatment satisfaction level, as well as a lack of satisfaction with other antimuscarinic treatments and higher rate of urge UI diagnosis. The same cohort also featured a lower level (P≤0.01) of caffeine abuse and lower share of salary spent purchasing solifenacin.ConclusionsThis study has shown that compliance with solifenacin treatment is associated with a number of significant medical, social, and economic factors. The medical factors included the type of urination disorder, severity of incontinence symptoms, presence of side effects, treatment efficacy and patients’ satisfaction with it, and experience using other antimuscarinic treatments. Among the social and economic factors, those with the strongest correlation to compliance were patient age, employment in medicine and education, annual income level, percentage of solifenacin purchase expenditures, and caffeine abuse. Factors with a weaker, but still significant, association were gender, employment in the transportation industry, and monthly income level.

Does BMI, gender or age affect efficacy/tolerability of solifenacin in the management of overactive bladder?

Pooled data from seven randomized placebo-controlled trials were analysed to evaluate relationships between baseline body mass index (BMI), gender or age and the efficacy/tolerability of solifenacin (5-10mg daily) in patients with overactive bladder (OAB). Changes in efficacy variables from baseline to 12weeks were compared in patients with symptoms at baseline between solifenacin-treated and placebo-treated groups. Normalization rates were calculated (no more than eight micturitions in 24h, no more than one episode of nocturia per night, zero values for other variables over 24h). Treatment-emergent adverse events (TEAEs) were recorded. The baseline incidence of incontinence and urgency incontinence increased with increasing BMI and age; relatively more women than men were incontinent. The baseline incidence of urgency was similar between genders and among age groups, but tended to increase with increasing BMI. The baseline frequencies of micturition and nocturia were similar in all BMI categories, between genders and in all age groups. The results from this meta-analysis of an integrated database of data from trials investigating solifenacin showed that solifenacin was more efficacious than placebo for all OAB symptoms across all BMI and age categories, and between genders. Normalization rates for micturition frequency, incontinence and urgency were greater in patients receiving solifenacin than in those receiving placebo across all categories. The overall incidence of TEAEs was higher in patients receiving solifenacin than in those receiving placebo; solifenacin was generally well tolerated in both groups. The overall frequency of TEAEs for solifenacin and placebo was slightly higher in women than in men and in older than in younger patients. The most commonly reported TEAEs were dry mouth and constipation. Regardless of BMI, gender or age, all patients with OAB can be considered candidates for solifenacin treatment.

Long-term prospective study of the persistence of solifenacin succinate in previously untreated Japanese female patients with overactive bladder.

To prospectively evaluate the persistence of solifenacin treatment in previously untreated Japanese female patients with overactive bladder. A total of 73 previously untreated Japanese female patients diagnosed with overactive bladder were given 5 mg of solifenacin once daily and prospectively followed for 3 years with periodic evaluations. The drug persistence rate was estimated using the Kaplan-Meier method. If solifenacin had to be terminated or a patient did not come to the hospital to receive a prescription, the reason was determined. After solifenacin treatment, the overactive bladder symptom score and average voided volume were significantly improved and maintained for 3 years. The 6-month, 1-year, 2-year and 3-year persistence rates were 50.7%, 41.1%, 32.9% and 23.3%, respectively. The major reasons for solifenacin therapy discontinuation were symptom resolution (27.4%) and adverse events (20.5%). Patients with nocturia three times or more at baseline had lower persistence than those with nocturia more than three times. Patients without detrusor overactivity at baseline had lower drug persistence than those with detrusor overactivity. Approximately one-quarter of previously untreated Japanese overactive bladder female patients continue solifenacin treatment for 3 years. Many patients discontinue solifenacin for various reasons, including symptom resolution and adverse events.

Dose Pattern Evolution and Therapeutic Benefit in Patients on Solifenacin or Fesoterodine Treatment in Daily Clinical Practice

Aim: To explore in daily clinical practice the evolution in time of the fesoterodine and solifenacin dose pattern and assess the therapeutic benefit provided by the highest dose of these anti-muscarinics. Patients and Methods: This was a post-hoc analysis of data from an observational, cross-sectional, retrospective and multicenter study. Adult patients diagnosed with over active bladder (OAB) who initiated fesoterodine or solifenacin treatment were included. Data on the prescribed treatment and dose, change of dose, reasons for switching and treatment benefit were recorded. Results: A total of 828 subjects were analyzed (262 receiving solifenacin and 566 fesoterodine). Most subjects were women with a mean time since diagnosis of more than one year and aged around 60 years old. The majority of patients initiated the OAB treatment with the lowest available dose (64% fesoterodine vs. 77% solifenacin). At the follow-up visit 54% of the fesoterodine group and 66% of the solifenacin opted for dose escalation. At the study visit, 70.1% fesoterodine vs. 43.3% solifenacin remained on the highest dose. A significantly greater proportion of subjects receiving fesoterodine 8 mg, reported higher improvement in terms of both patient-reported-treatment benefit and clinical global impression compared with solifenacin 10 mg (p < 0.05). Conclusion: In routine clinical practice more than half of the patients opted for the higher dose and remained on it over time, suggesting a desire for greater efficacy. Fesoterodine 8 mg seems to provide greater benefits from the physician’s and the patient’s point of view compared with those provided by solifenacin 10 mg.

The use of biomarkers in the diagnosis and treatment of overactive bladder: Can we predict the patients who will be resistant to treatment?

The main objective of this study was to define urinary biomarkers that can predict the severity of overactive bladder and detect patients who would benefit most from treatment. Patients with an OAB diagnosis and healthy controls were included in the study. A bladder diary and a validated OAB questionnaire were given to all patients. In the OAB group, solifenacin 5 mg daily was given for 1 month. Urine samples were taken before the treatment and after the first month of the treatment in both groups and urinary BDNF, NGF, GAG, and MCP-1 levels were measured. A total of 45 OAB patients and 45 healthy age-matched controls were included. BDNF/Cre, NGF/Cre, MCP-1/Cre, and GAG/Cre levels were significantly higher in the OAB group. The levels of these biomarkers significantly decreased after 1 month of solifenacin treatment. After treatment, 66.7% of patients OAB symptoms were relieved and 33.3% did not respond to the treatment. Although basal biomarker levels did not differ between responder and non-responder groups, the ratio of decrease in biomarker levels was significantly higher in treatment-sensitive patients. Postmenopausal women were more resistant to treatment when compared with the premenopausal group. Urinary biomarkers have a role in the pathophysiology of OAB however they did not predict the patients who would benefit from the treatment and in whom antimuscarinics would be useless. Future studies with higher numbers of patients and different OAB subgroups are needed to investigate the exact role of these (and other) biomarkers. Neurourol. Urodynam. 36:390-393, 2017. © 2015 Wiley Periodicals, Inc.

Urinary nerve growth factor and a variable solifenacin dosage in patients with an overactive bladder

We evaluated changes in urinary nerve growth factor (NGF) and NGF/creatinine (NGF/Cr) levels after increasing the dosage of solifenacin in overactive bladder patients. The study groups included 59 overactive bladder (OAB) patients and 20 healthy subjects as controls. We measured NGF at baseline for the patients and controls, and used the Overactive Bladder Awareness Tool (OAB-V8) to evaluate urinary symptoms. All patients received a treatment of solifenacin 5 mg for 6 weeks. The responders to treatment served as group 1 and nonresponders received solifenacin 10 mg for an additional 6 weeks. Responders and nonresponders to the 10-mg treatment were defined as groups 2 and 3 respectively. NGF was measured after each treatment using the ELISA method and normalized by the urinary creatinine levels (NGF/Cr). There were 21, 22 and 16 patients in groups 1, 2, and 3 respectively. At baseline, the NGF and NGF/Cr levels were higher in groups 1, 2, and 3 compared with the controls. After the solifenacin 5 mg treatment, the NGF and NGF/Cr levels of group 1 individuals decreased to those of the control level. After increasing the dosage of solifenacin to 10 mg in group 2, the NGF and NGF/Cr levels decreased to normal levels. In group 3 (patients who did not responded to any treatment), these levels remained unchanged. Our results suggest that urinary NGF could be a potential biomarker for monitoring the treatment of symptoms in OAB patients who are treated with solifenacin.

A commentary on: "Anti-muscarinic adjunct therapy accelerates functional human oligodendrocyte repair".

A commentary on: "Anti-muscarinic adjunct therapy accelerates functional human oligodendrocyte repair".

Anti-muscarinic adjunct therapy accelerates functional human oligodendrocyte repair.

Therapeutic repair of myelin disorders may be limited by the relatively slow rate of human oligodendrocyte differentiation. To identify appropriate pharmacological targets with which to accelerate differentiation of human oligodendrocyte progenitors (hOPCs) directly, we used CD140a/O4-based FACS of human forebrain and microarray to hOPC-specific receptors. Among these, we identified CHRM3, a M3R muscarinic acetylcholine receptor, as being restricted to oligodendrocyte-biased CD140a(+)O4(+) cells. Muscarinic agonist treatment of hOPCs resulted in a specific and dose-dependent blockade of oligodendrocyte commitment. Conversely, when hOPCs were cocultured with human neurons, M3R antagonist treatment stimulated oligodendrocytic differentiation. Systemic treatment with solifenacin, an FDA-approved muscarinic receptor antagonist, increased oligodendrocyte differentiation of transplanted hOPCs in hypomyelinated shiverer/rag2 brain. Importantly, solifenacin treatment of engrafted animals reduced auditory brainstem response interpeak latency, indicative of increased conduction velocity and thereby enhanced functional repair. Therefore, solifenacin and other selective muscarinic antagonists represent new adjunct approaches to accelerate repair by engrafted human progenitors.

Do Effects on Bowel Patterns Imposed by Solifenacin Always Have Negative Impacts on Treating Patients with Overactive Bladder (OAB)?

To investigate whether solifenacin intervention leads to any changes in bowel symptoms, and the types of impacts imposed on bowel symptoms in patients with overactive bladder (OAB). This prospective, single-arm observational study included 40 adult patients who underwent anticholinergic treatment for OAB. Outcome measures were determined by examining differences in voiding and bowel symptoms, before and after patients commenced anticholinergic therapy. Patients were evaluated at baseline, 4, and 12 weeks via questionnaires on OAB and irritable bowel syndrome (IBS), side-effects, and overall satisfaction with the treatment. A total of 22 patients completed follow-up visits. Mean age was 62.1 ± 10.3 years. The most common side-effects were constipation and dry mouth. OAB symptom scores improved, with significant changes in urgency, incontinence, and total symptom scores and borderline significant changes in frequency. All bowel symptoms except diarrhea became aggravated. Average constipation and overall quality of life worsened with significance. Aside from the specific bowel habit changes, solifenacin treatment resulted in changes in patient status of IBS, as well. Patients were mostly satisfied with the treatment, despite some aggravations in discomfort due to defecation problems. This study shows that solifenacin treatment is effective for treating urinary incontinence but may lead to changes in bowel patterns and affects overall quality of life (QoL). Effects on bowel patterns imposed by solifenacin can be positive or negative, therefore, physicians should consider more holistic therapy by addressing overall bowel symptoms when treating OAB patients.

A prospective, observational study to assess the association between dry mouth and solifenacin treatment in patients with overactive bladder syndrome.

Dry mouth is among the most common side effects of antimuscarinic therapy. This study evaluated the drug-related change in dry mouth after the solifenacin treatment and the impact of dry mouth on the drug efficacy against overactive bladder syndrome (OAB). OAB patients (n = 331) were enrolled in a prospective, multicenter, 8-week observational study of solifenacin treatment. Participants were >20 years of age and presented with OAB symptoms for ≥3 months, a total overactive bladder symptom score (OABSS) of ≥3, and an urgency score of ≥2. Primary endpoints were changes in dry mouth according to baseline dry mouth status using Xerostomia Inventory (XI) and the effect of dry mouth to the drug efficacy according to improvements in the OABSS. Three hundred and thirty-three patients were initially screened for the study, with 331 actually enrolled. One hundred and ninety-four patients completed the study. Mean total XI scores increased by 2.8 points in the entire patient population, with larger increases for patients stratified into the non-dry mouth group (NDG) versus the dry mouth group (DG) (4.0 vs. 1.9, p = 0.015) at study baseline. Mean total OABSSs decreased by 3.2 points, with no significant differences between the NDG and the DG (-3.4 vs. -3.0 points, p = 0.578). The dry mouth aggravated in 71 patients (29.2 %) (NDG 30.1 % and DG 27.1 %), but only 10/331 individuals (3.0 %) stopped medication due to xerostomia. Dry mouth progressed in approximately 30 % of the OAB patients, regardless of its presence before solifenacin treatment. However, OAB symptoms were well relieved by solifenacin, and the adverse influence of dry mouth on drug persistence was low.

PD23-12 LONG-TERM EFFICACY AND SAFETY OF ALPHA 1-BLOCKER NAFTOPIDIL FOR PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA: 3-YEAR OUTCOME ANALYSIS OF A PROSPECTIVE MULTICENTER STUDY.

METHODS: This prospective study was conducted in 155 men 49-86 years of age who visited our hospital and opted for medical treatment consisting of BPH with dutasteride. Fifty treated with dutasteride 0.5 mg daily for at least 6 months and who had persistent OAB symptoms (OAB Symptom Score (OABSS) 5) were enrolled. These patients were treated for the OAB symptoms with either solifenacin 5 mg/day or mirabegron 50 mg/day for 12 weeks (N1⁄425 in each) and evaluated by the International Prostate Symptom Score (IPSS) and OABSS just before and 4 and 12 weeks after solifenacin or mirabegron treatment. Postvoided residual urine volume (PVR) and the incidence of adverse events were also evaluated. RESULTS: Mean values of prostate volume, PVR, IPSS, and OABSS just before administration of solifenacin or mirabegron were 39.0 ml, 53.2 ml, and 17.6, 8.1, respectively, and these parameters were not significantly different between the two groups. The changes of IPSS and OABSSwere -2.0 and -2.0 at 4 weeks and -3.1 and -2.7 at 12 weeks after solifenacin treatment, respectively, which were significantly lower than those just before the administration. Four patients treatedwith solifenacin could not continue due to adverse events; 3 caseshaddysuria and1 case hadblurred vision.Thechangesof IPSSandOABSSwere -3.3 and -1.7 at 4 weeks and -3.0 and -2.5 at 12 weeks after mirabegron treatment, respectively, which were significantly lower than those just before the administration. All patients continued the mirabegron treatment. The incidence of minor adverse events was 12 and 7 cases in solifenacin and mirabegron treatment, respectively. Two and no patients had more than 100 ml PVR after solifenacin and mirabegron treatment, respectively. CONCLUSIONS: Solifenacin and mirabegron are effective in BPH patients treated with dutasteride but having OAB symptoms.

PD8-05 THE PARACRINE EFFECTS OF MESENCHYMAL STEM CELLS STIMULATE THE REGENERATION CAPACITY OF ENDOGENOUS STEM CELLS IN THE REPAIR OF A BLADDER OUTLET OBSTRUCTION-INDUCED OVERACTIVE BLADDER

You have accessJournal of UrologyStem Cell Research1 Apr 2014PD8-05 THE PARACRINE EFFECTS OF MESENCHYMAL STEM CELLS STIMULATE THE REGENERATION CAPACITY OF ENDOGENOUS STEM CELLS IN THE REPAIR OF A BLADDER OUTLET OBSTRUCTION-INDUCED OVERACTIVE BLADDER Miho Song, Ji-Youn Chun, Junsoo Park, Ji-Yeon Han, Dong-Myung Shin, Myung-Soo Choo, and Sang Hoon Song Miho SongMiho Song More articles by this author , Ji-Youn ChunJi-Youn Chun More articles by this author , Junsoo ParkJunsoo Park More articles by this author , Ji-Yeon HanJi-Yeon Han More articles by this author , Dong-Myung ShinDong-Myung Shin More articles by this author , Myung-Soo ChooMyung-Soo Choo More articles by this author , and Sang Hoon SongSang Hoon Song More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.799AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The efficacies of current pharmacotherapies using antimuscarinic agents to treat overactive bladder (OAB) are insufficient. To evaluate the therapeutic efficacies of mesenchymal stem-cells (MSCs) and current pharmacotherapies for the treatment of OAB and investigate the therapeutic mechanisms involved in MSC therapy. METHODS OAB was induced in 50 female 6-week-old Sprague Dawley rats by partial bladder-outlet-obstruction (BOO). Ten rats underwent sham operations. Four-weeks after inducing BOO, 50 rats with BOO were divided among 3 groups and received a single transplantation of human adipose-derived MSCs or daily intravenous injections of solifenacin (an antimuscarinic agent) or PBS for 2-weeks. Cystometric parameters, histological examinations, immunostaining for α-SMA, N200, Oct4, and Stella, and the transcriptional activity levels for stemness and stem-cell trafficking genes were measured at 2- and 4-weeks after intervention. RESULTS Both the MSC and solifenacin treatments similarly relieved BOO-induced detrusor overactivity, hypertrophic smooth muscle, and neurological injuries within 2-weeks. In contrast to solifenacin treatment, a single transplantation of MSC improved most OAB parameters to the basal level within 4-weeks. Although the transplanted stem cells were hardly engrafted, the bladders that received MSCs increased the transcription of Oct4, Sox2, and Stella in the experimental rats, which are surrogate markers of pluripotent stem-cells. In addition, MSCs enhanced the expression levels of several genes responsible for stem-cell trafficking. These changes in gene expression were not observed in the solifenacin-treated group. CONCLUSIONS These results indicate that a single transplantation of MSCs can repair bladder function better than current pharmacotherapies due to BOO-induced OAB. Moreover, we suggest that the novel mechanisms for the ¡§paracrine effect¡¨ of MSCs unleash and mobilize primitive endogenous stem-cells, which could not only explain the long-term/stable therapeutic efficacy of MSC therapy but also provide promising new therapies for OAB. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e218 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Miho Song More articles by this author Ji-Youn Chun More articles by this author Junsoo Park More articles by this author Ji-Yeon Han More articles by this author Dong-Myung Shin More articles by this author Myung-Soo Choo More articles by this author Sang Hoon Song More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Clinical factors associated with dose escalation of solifenacin for the treatment of overactive bladder in real life practice.

PurposeTo determine the baseline clinical characteristics associated with dose escalation of solifenacin in patients with overactive bladder (OAB).MethodsWe analyzed the data of patients with OAB (micturition frequency ≥8/day and urgency ≥1/day) who were treated with solifenacin and followed up for 24 weeks. According to our department protocol, all the patients kept voiding diaries, and OAB symptom scores (OABSS) were monitored at baseline and after 4, 12, and 24 weeks of solifenacin treatment.ResultsIn total, 68 patients (mean age, 60.8±10.0 years) were recruited. The dose escalation rate by the end of the study was 41.2%, from 23.5% at 4 weeks and 17.6% at 12 weeks. At baseline, the dose escalator group had significantly more OAB wet patients (53.6% vs. 20.0%) and higher total OABSS (10.2±2.4 vs. 7.9±3.5, P=0.032) than the nonescalator group. OAB wet (odds ratio [OR], 4.615; 95% confidence interval [CI], 1.578-13.499; P<0.05) and total OABSS (OR, 1.398; 95% CI, 1.046-1.869; P<0.05) were found to be independently associated with dose escalation.ConclusionsPatients who have urgency urinary incontinence and high total OABSS have a tendency for dose escalation of solifenacin.

Solifenacin in Women with De Novo Overactive Bladder after Tension-Free Obturator Vaginal Tape—Is it Effective?

To our knowledge no group has evaluated antimuscarinic efficacy in patients with de novo overactive bladder after mid urethral sling placement. We assessed solifenacin efficacy in women with de novo overactive bladder after obturator tension-free vaginal tape placement compared to a control group. We prospectively considered all women with de novo overactive bladder symptoms at a 3-month followup visit after placement of obturator tension-free vaginal tape. Patients with overactive bladder preoperatively and those with obstructive symptoms or signs were excluded from analysis. Women who satisfied inclusion and exclusion criteria (group 1) were compared with a series of consecutive naïve patients with overactive bladder symptoms without a previous surgical procedure for stress urinary incontinence (group 2). We prescribed 12-week antimuscarinic therapy with oral solifenacin 5 mg once daily. Objective outcomes included changes from baseline in 3-day voiding diary data. Subjective efficacy was evaluated using the Overactive Bladder Questionnaire Short Form, Urgency Severity Scale and Patient Global Impression of Improvement questionnaires. A total of 110 patients with de novo overactive bladder after obturator tension-free vaginal tape placement completed solifenacin treatment and were included in group 1. They were compared with 120 consecutive naïve women with overactive bladder (group 2). Group 1 presented at the 3-month followup visit with significantly less benefit in the mean decrease in urgency and urgency urinary incontinence episodes daily (-1.1 vs -2.3 and -0.2 vs -1.1, respectively, each p <0.0001). In group 1 we also found a lower subjective solifenacin effect. Previous obturator tension-free vaginal tape placement was an independent predictor of failed solifenacin treatment. Antimuscarinic treatment with solifenacin had significantly lower efficacy in women with de novo overactive bladder after mid urethral sling placement than in controls.

Patient-reported outcome of solifenacin treatment among women experiencing urinary urgency and urgency incontinence

ObjectiveTo evaluate treatment success and tolerability of solifenacin among women with urinary urgency (UU) and urgency urinary incontinence (UUI). MethodsIn a prospective, observational, multicenter pilot study in Slovenia and Croatia, 100 women with UU and UUI were enrolled between January 2011 and July 2011. Patients received 5mg of solifenacin once daily for 12weeks and completed a 3-day bladder diary, urgency questionnaire, Urogenital Distress Inventory (UDI), and Incontinence Impact Questionnaire (IIQ). ResultsOverall, 91 women completed 12weeks of treatment. Severity, frequency, and bother of UU significantly had decreased at weeks 4 and 12 (P<0.001). Improvement in UU led to an improvement in mean IIQ score: a reduction in UU frequency had the greatest impact (P=0.006). The mean treatment success rate was 74.2% (by visual analog score) and was closely related to the mean change in irritative UDI score (r=0.39; P<0.001). Treatment success was greatest for patient perception of intensity of urgency scale (PPIUS; P=0.003), UU bother (P=0.017), and micturition frequency (P<0.026). Dry mouth occurred in 35.2% of women at 4weeks, and 27.7% at week 12. ConclusionSolifenacin treatment was effective and well-tolerated among women with UU and UUI. All overactive bladder symptoms had improved by week 12.

Editorial Comment

Pharmacologic treatment of symptoms of overactive bladder (OAB) has been based on antimuscarinic treatment for over 30 years. Clinical research has shown significant improvement of patient symptoms and quality of life with a dry rate (on a 3-day voiding diary) of approximately 50% in patients with urgency incontinence. 1 Haab F. Cardozo L. Chapple C. et al. Long-term open-label solifenacin treatment associated with persistence with therapy in patients with overactive bladder syndrome. Eur Urol. 2005; 47: 376-384 Abstract Full Text Full Text PDF PubMed Scopus (142) Google Scholar Evidence from real-life practice tampered the initial enthusiasm showing a low adherence to the prescribed regimen, with most patients discontinuing treatment within a year because of lack of efficacy and side effects. 2 Benner J.S. Nichol M.B. Rovner E.S. et al. Patient-reported reasons for discontinuing overactive bladder medication. BJU Int. 2010; 105: 1276-1282 Crossref PubMed Scopus (303) Google Scholar , 3 Linner L. Schioler H. Samuelsson E. et al. Low persistence of anticholinergic drug use in Sweden. Eur J Clin Pharmacol. 2011; 67: 535-536 Crossref PubMed Scopus (19) Google Scholar Nevertheless, antimuscarinics remain as life-saving drugs for patients with spinal chord injury showing a powerful level of activity in these patients. A Phase III, Randomized, Double-blind, Parallel-group, Placebo-controlled, Multicentre Study to Assess the Efficacy and Safety of the β3 Adrenoceptor Agonist, Mirabegron, in Patients With Symptoms of Overactive BladderUrologyVol. 82Issue 2PreviewTo assess the efficacy and tolerability of mirabegron 25 mg and 50 mg once-daily vs placebo in patients with overactive bladder (OAB). Full-Text PDF ReplyUrologyVol. 82Issue 2PreviewThis was a good editorial comment and we thank the editors for the appreciation of the positive outcome with mirabegron in patients with the overactive bladder syndrome (OAB). Indeed we are enthusiastic about the efficacy and limited side effects of this first drug of a new pharmacologic class approved by the Food and Drug Administration and available for the treatment of patients with symptoms of OAB. We see mirabegron as a welcome additional therapeutic modality for patients with OAB that does not show sufficient clinical efficacy with other forms of pharmacologic treatment. Full-Text PDF

Reproducibility study of Overactive Bladder Symptom Score questionnaire and its response to treatment (RESORT) in Korean population with overactive bladder symptoms

The Overactive Bladder Symptom Score (OABSS) is comprised of 4 items with a single total score for quantification of OAB symptoms and has been reported as sensitive to treatment-related changes. The aim of this study was to assess the psychometric properties of the Korean version in patients with OAB symptoms. Two prospective trials were conducted at two teaching hospitals. The Part I study evaluated the internal consistency and test-retest reliability among 42 enrolled patients, and the Part II trial assessed the construct validity and anticholinergic responsiveness in 50 enrolled patients and 50 controls. Internal consistency was found acceptable, with Cronbach's α of 0.73 for total OABSS score. From a 2-week test-retest, Spearman's rho of each item ranged from 0.53 to 0.82, and the intraclass correlation coefficient of the total score was 0.80, showing the high stability. Acceptable discriminant validity was demonstrated, with substantially different correlations of OABSS scores with an International Prostate Symptom Score-storage and voiding score sum, and significant differences between patients and controls. Convergent validity was acceptable, with moderate correlations between each OABSS item and the corresponding 3-day frequency-volume chart variables. The Korean version was found considerably responsive to symptom changes following 12-week solifenacin treatment, as judged by moderate or large effect sizes, standardized response means, and the Guyatt Responsiveness Index. With good psychometric properties and responsiveness, the Korean version of the OABSS may offer researchers and clinicians a valid and reliable measure for the assessment of OAB symptoms in the Korean population.

The Effect of Solifenacin on Cognitive Function following Stroke

Background/Aims: Our aim was to investigate the effect of solifenacin (an anticholinergic) on cognitive function after stroke. Methods: We retrospectively reviewed 66 stroke cases who were prescribed solifenacin for more than 2 months. A control group was generated matching the patients both for sex and age. The interval changes in the Mini-Mental State Examination (MMSE) score and Clinical Dementia Rating Sum of Boxes (CDR-SB) score after solifenacin administration were compared to those of the control group. Results: The baseline MMSE score of the control group was 15.9 ± 9.2 and that of the solifenacin group was 14.3 ± 7.8. After using solifenacin for an average of 76.9 days, there was a change in the MMSE score of 1.9 ± 5.2. During similar periods, there was a change in the MMSE score of 2.9 ± 3.7 in the control group (not using solifenacin). However, there was no significant difference between the two groups. Similarly, there was no significant difference in the CDR-SB score between the two groups. Conclusion: Solifenacin treatment did not affect the short-term cognitive performance in stroke patients. This information might be useful when prescribing anticholinergics to stroke patients.

1850 CORRELATION OF URINARY OXIDANT STRESS MARKER LEVEL WITH THE RESPONSE OF ANTIMUSCARINIC THERAPY IN PATIENTS WITH FEMALE OVERACTIVE BLADDER

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Female Urology (II)1 Apr 20131850 CORRELATION OF URINARY OXIDANT STRESS MARKER LEVEL WITH THE RESPONSE OF ANTIMUSCARINIC THERAPY IN PATIENTS WITH FEMALE OVERACTIVE BLADDER Teruhiko Yokoyama, Shinjiro Shimizu, Kazuhiko Fukumoto, Yoshiyuki Miyaji, and Atsushi Nagai Teruhiko YokoyamaTeruhiko Yokoyama Kurashiki, Japan More articles by this author , Shinjiro ShimizuShinjiro Shimizu Kurashiki, Japan More articles by this author , Kazuhiko FukumotoKazuhiko Fukumoto Kurashiki, Japan More articles by this author , Yoshiyuki MiyajiYoshiyuki Miyaji Kurashiki, Japan More articles by this author , and Atsushi NagaiAtsushi Nagai Kurashiki, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2269AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recent animal study demonstrated that oxidative stress and inflammation may be key factors in the development of overactive bladder (OAB) and increased bladder activity is associated with elevated oxidative stress markers (Neurourol Urody 31: 185, 2012). In this study, we explored the correlation the level of the urinary oxidative stress marker 8-hydroxy-2`-deoxyguanosine (8-OHdG) with response after antimusucarinic therapy in female patients with OAB. METHODS Urinary 8-OHdG levels were measured in 20 female patients (median 70.0 years old) with OAB. Patients were treated with solifenacin 5 mg once a daily. Urine samples were collected before, 1 and 3 months after treatment. Evaluations included International Prostate Symptom Score (IPSS), QOL index and Overactive Bladder Symptom Score (OABSS) before and 1, 3 months after treatment. Effects on bladder function was evaluated before and 3 months after treatment by filling cystometry. Urinary 8-OHdG levels were measured by enzyme-linked immunosorbent assay technique (ELISA) and the results were normalized based on creatinine (Cr) concentration. A p value of less than 0.05 was considered statistically significant. RESULTS Average IPSS, QOL index, OABSS were significantly improved from 16.0, 5.3, and 10.1 at baseline to 9.3, 3.0, and 5.9 at 1 month, to 7.4, 2.4, and 5.1 at 3 months after treatment. Urinary 8-OHdG levels did not decrease from 11.8±5.7 ng/mg Cr at baseline to 12.2±6.2 ng/mg Cr at 1 month (p=0.556), but significantly decreased from baseline to 7.9±3.8 ng/mg Cr at 3 month (p=0.0464) after treatment. As to cystmetric findings, volume of first desire to void and maximum cystometric capacity significantly increased from 114±41.7ml, 279±95.0 ml at baseline to 151±38.9 ml, 316±79.7 ml at 3 months, respectively. CONCLUSIONS Solifenacin treatment was subjectively and objectively effective for female OAB patients. The urinary 8-OHdG levels significantly decreased after antimuscarinic therapy with solifenacin. It could provide important information on clinical significance between oxidative stress and OAB. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e759 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Teruhiko Yokoyama Kurashiki, Japan More articles by this author Shinjiro Shimizu Kurashiki, Japan More articles by this author Kazuhiko Fukumoto Kurashiki, Japan More articles by this author Yoshiyuki Miyaji Kurashiki, Japan More articles by this author Atsushi Nagai Kurashiki, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Analiza objawów pęcherza nadreaktywnego po przerwaniu terapii solifenacyną

Analiza objawów pęcherza nadreaktywnego po przerwaniu terapii solifenacyną