Indirect treatment comparison (ITC) of medical therapies for an overactive bladder

Obloza, Aneta; Kirby, Joshua; Toozs‐Hobson, Philip

doi:10.1002/nau.23189

Cited by 5 publications

(3 citation statements)

References 44 publications

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“…Although we identified four systematic reviews/meta-analyses that have been published in recent years [74–77], our review differs in several ways. Other systematic reviews set one of the pharmacotherapies as standard therapy, comparing all other treatments to the standard, while we addressed all relevant comparisons using only direct evidence, not relying on placebo-controlled trial evidence.…”

Section: Discussionmentioning

confidence: 99%

Updating the evidence on drugs to treat overactive bladder: a systematic review

et al. 2019

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IntroductionOveractive bladder (OAB) is a common condition, increasing with age and affecting quality of life. While numerous OAB drugs are available, persistence is low. We evaluated evidence published since 2012 to determine if newer drugs provided better efficacy and harm profiles.MethodsWe searched MEDLINE and the Cochrane Library from 2012 to September 2018 using terms for included drugs and requested information from manufacturers of included drugs. We performed dual review of all systematic review processes, evaluated study quality, and conducted meta-analyses using random effects models.ResultsIn addition to 31 older studies, we included 20 trials published since 2012 (N = 16,478; 4 good, 11 fair, and 5 poor quality). Where statistical differences were found, they were clinically small (reductions of < 0.5 episodes/day). Solifenacin plus mirabegron improved efficacy outcomes over monotherapy with either drug, but significantly increased constipation compared with solifenacin and dry mouth compared with mirabegron. Solifenacin reduced incontinence over mirabegron and tolterodine and urgency episodes over tolterodine. Mirabegron did not differ from tolterodine in efficacy but had significantly lower incidence of dry mouth than solifenacin or tolterodine. Fesoterodine showed significant improvements but also anticholinergic effects vs. tolterodine. Oxybutynin, solifenacin, and tolterodine had similar efficacy, but dry mouth led to greater discontinuation with oxybutynin. Blurred vision, cardiac arrhythmia, and dizziness were uncommon.ConclusionNew evidence confirms small, but clinically uncertain, differences among monotherapies and also between combination and monotherapy, regardless of statistical significance. While drugs mainly differed in incidence of dry mouth or constipation, none provided improved efficacy without increased harms.Electronic supplementary materialThe online version of this article (10.1007/s00192-019-04022-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Updating the evidence on drugs to treat overactive bladder: a systematic review

et al. 2019

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“…Random-effects modelling was selected a priori over fixed effects models taking into account both within and between studies heterogeneity given differences in RCT design. Therefore, the strength of randomization is partially maintained and any differences between treatments that are observed through an indirect comparison are less likely due to patient differences unrelated to the treatment [ 10 ]. Indirect comparisons and statistical tests were presented using STATA version 14.2 (Stata Corp., College Station, TX, USA) software.…”

Section: Methodsmentioning

confidence: 99%

Indirect comparison of efficacy between different antibiotic prophylaxis against the intracranial infection after craniotomy

Cao

Wang

Shan

et al. 2020

Antimicrob Resist Infect Control

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Background Many studies had shown that prophylactic use of antibiotics could significantly reduce the intracranial infection (ICI) rate of craniotomy. However, there has been no comparison of these antibiotics. Methods An electronic database search was performed, from inception to June 102,020. Randomized controlled trials (RCT) using different intravenous antibiotics (IVA) against the ICIs after craniotomy were considered. The primary outcome was the incidence rates of ICIs. An indirect treatment comparison (ITC) was conducted to compare the protective effect among the diverse antibiotic prophylaxis to prevent ICIs after craniotomy. Risk of potential bias was assessed. Results A total of 3214 patients after craniotomy in 11 studies were included, 159 patients experienced postoperative ICI, including 33 patients in the antibacterial group and 126 in the control group. The calculate results of meta-analysis showed that except fusidic acid, preoperative intravenous injection of cephalosporin, clindamycin, vancomycin, and penicillin can significantly reduce the incidence of ICI after craniotomy, and ITC showed there was no statistically significance difference in the rates of post craniotomy ICI between the various antibiotics. Conclusion The current evidence shows that low-grade antibacterial drugs can be selected to prevent ICI after craniotomy, but this may be due to the limited number of studies per antibiotic. It still needs more high-quality, large sample RCT to confirm. Systemic review registration PROSPERO CRD42019133369.

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“…Accordingly, beta-3 agonist may become first-line drug therapy for OAB. Alternatively, a more tailored approach matching therapy to characteristics of the individual patients presenting may become the aspiration (3). Comparative studies of mirabegron against antimuscarinics are few, but the efficacy of the drug appears to match that of better antimuscarinics.…”

mentioning

confidence: 99%

Long-term adherence to clinical therapy of overactive bladder

Drake

2017

Transl. Androl. Urol.

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Indirect treatment comparison (ITC) of medical therapies for an overactive bladder

Cited by 5 publications

References 44 publications

Updating the evidence on drugs to treat overactive bladder: a systematic review

Updating the evidence on drugs to treat overactive bladder: a systematic review

Indirect comparison of efficacy between different antibiotic prophylaxis against the intracranial infection after craniotomy

Long-term adherence to clinical therapy of overactive bladder

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