Yearly Trends of Overactive Bladder Medication Usage

Chua, Kevin; Patel, Hiren V.; Tabakin, Alexandra L.; Srivastava, Arnav; Doppalapudi, Sai Krishnaraya; Hyams, Elias S.; Tunuguntla, Hari Siva Gurunadha Rao

doi:10.1097/upj.0000000000000243

Cited by 14 publications

(13 citation statements)

References 24 publications

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“…According to Medicare Part D national data set, oxybutynin and mirabegron were the most commonly prescribed OAB medications from 2014 to 2018. This is consistent with our findings because most case reports were from oxybutynin (27%) and mirabegron (35%) 7–9 . As expected, oxybutynin had the least proportion of NP ADEs given the majority of the administration is transdermal.…”

Section: Discussionsupporting

confidence: 92%

“…This is consistent with our findings because most case reports were from oxybutynin (27%) and mirabegron (35%). [7][8][9] As expected, oxybutynin had the least proportion of NP ADEs given the majority of the administration is transdermal. However, within NP subcategories, transdermal oxybutynin was associated with an increased risk of affect/mood disorder, agitation, and balance/movement disorder compared with all other OAB medications.…”

Section: Discussionsupporting

confidence: 65%

“…Oxybutynin, solifenacin, and mirabegron made up most of the database because they are prescribed more often. Syan et al 17 looked a prescription drug insurance database from 2003 to 2016 and found an uptrend in mirabegron prescriptions and reciprocal downtrend of antimuscarinic prescriptions 9 . Because FAERS data does not provide causality, the reason for more frequent reporting of mirabegron is not obvious.…”

Section: Discussionmentioning

confidence: 99%

“…Syan et al 17 looked a prescription drug insurance database from 2003 to 2016 and found an uptrend in mirabegron prescriptions and reciprocal downtrend of antimuscarinic prescriptions. 9 Because FAERS data does not provide causality, the reason for more frequent reporting of mirabegron is not obvious. It could be that mirabegron is prescribed more often because of better patient tolerability; consequently, ADEs are more likely to be reported.…”

Section: Faers and Oab Medication Adverse Effectsmentioning

confidence: 99%

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Adverse Events for Overactive Bladder Medications From a Public Federal Database

Sze

Drangsholt

Stoddard

et al. 2022

Female Pelvic Med Reconstr Surg

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ImportanceClinical data on the use of overactive bladder (OAB) medications are limited by the physician interpretation of adverse effects rather than those that are patient reported.ObjectiveThe aim of the study was to evaluate the association between OAB medications and adverse drug events (ADEs) through the self-reporting U.S. Food and Drug Administration Adverse Event Report System database.Study DesignThe U.S. Food and Drug Administration Adverse Event Report System (FAERS) database was queried from 2004 to 2019. Adverse drug events were recategorized. Disproportionality analysis was used to detect the risk signals for each OAB medication and ADEs. χ2 values were calculated to assess the association between ADEs and dosage.ResultsA total number of 14,102 reports were identified. The most frequently reported OAB medications were mirabegron (35%), transdermal oxybutynin (27%), and solifenacin (25%). Neuropsychiatric (NP) ADEs were highest with tolterodine and fesoterodine usage (16% and 15.6%, respectively) and transdermal oxybutynin had the lowest (6.5%). Increasing the dose of tolterodine or fesoterodine was not associated with increased NP ADEs. Oxybutynin had the highest risk of affect/mood disorder, agitation, and balance/movement disorder; however, it had the lowest risk of headache/migraine compared with all OAB medications. Mirabegron compared with all other OAB medications had the lowest risk of affect/mood disorder and agitation; however, it had the highest risk of headache and migraines.ConclusionsThe FAERS database not only is a repository of ADEs but also may represent evolving prescribing habits for OAB medications. Transdermal oxybutynin had the lowest NP ADEs and may be appropriate for selected individuals.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Faers and Oab Medication Adverse Effectsmentioning

confidence: 99%

See 2 more Smart Citations

Adverse Events for Overactive Bladder Medications From a Public Federal Database

Sze

Drangsholt

Stoddard

et al. 2022

Female Pelvic Med Reconstr Surg

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“…They also showed that antimuscarinics (trospium, darifenacin, and fesoterodine), which produce lower cognitive side effects, were preferred for later stages of treatment. 34 In our study, among the antimuscarinic preferences in elderly OAB patients, trospium (URO 27.5%, GER 42.9%) and solifenacin (URO 27%, GER 20.6%) were the preferred drugs by URO and GER, while solifenacin (22%), oxybutynin (15.7%), and tolterodine (15.3%) were preferred by OB/GYNs. The quaternary molecular structure of trospium and noncrossing capability of blood-brain barrier of trospium might be the reason for choosing for this molecule.…”

Section: Discussionmentioning

confidence: 59%

Clinical preferences and treatment attitudes among urologists, gynecologists, and geriatricians: An independent online questionnaire survey for comparison of treatment choices in the management of overactive bladder

Onur

Bayrak

Çoşkun

et al. 2022

Neurourology and Urodynamics

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Objective Overactive bladder (OAB) is a common clinical problem with associated morbidities both in men and women. Although real‐life management strategies have been examined among urologists (URO), treatment choices may differ between different specialties. In the present study, an online survey was conducted to determine and compare the management strategies and clinical preferences of UROs, obstetricians/gynecologists (OB/GYN), and geriatricians (GER) in the treatment of OAB in their daily practices. Methods Between December 2020 and February 2021, an online questionnaire was sent to URO, OB/GYN, and GER specialists/residents. Current strategies and attitudes toward treatment of OAB in patients <65 years were compared between URO and OB/GYN, whereas the responses were compared between all three specialties in patients ≥65 years. Results A total of 733 specialists/physicians (433 URO, 236 OB/GYN, and 64 GER) completed the online survey. Patients with OAB were more likely to present to URO compared to OB/GYN and GER (p = 0.001). A combination of behavioral modification and pharmacotherapy (antimuscarinics and/or beta‐3 agonists) were chosen for the initial treatment of patients with OAB in both specialties with a significantly higher proportion by URO than by OB/GYN (51.9% vs. 38.1%; p = 0.001). Antimuscarinics were the most frequently prescribed medications by both the URO and OB/GYN specialties (81.8% vs. 78.4%; p = 0.27). Combination therapy with antimuscarinics was preferred more often by URO (91.5% vs. 77.1%; p = 0.001) when no or an inadequate response after initial treatment occurred. Multiple medication use, comorbidities, and risk of cognitive side effects affected medication preference by all specialists, especially by GER (p = 0.018). Conclusions Patients with OAB present to UROs, OB/GYN and GER more frequently compared to other specialities. Although antimuscarinics and beta‐3 adrenoceptor agonists are equally recommended as first‐line pharmacotherapy for OAB, antimuscarinics were preferred for most patients as the initial molecule by all specialties. Beta‐3 agonists are increasingly preferred for elderly patients.

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Trends in Overactive Bladder Therapy: Associations Between Clinical Care Pathways, Practice Guidelines, and Therapy Utilization Patterns

Mohamud,

Sinclair,

Gunamany

et al. 2024

Neurourology and Urodynamics

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IntroductionOveractive bladder (OAB) is a chronic condition with significant financial and health‐related consequences. Guidelines and treatment pathways were created to optimize care and provide a clinical framework for diagnosing and managing OAB. However, the impact of these efforts and patterns of medical treatment for OAB are poorly understood. Therefore, we sought to evaluate overall trends in therapy utilization before and after the 2014 American Urological Association (AUA)/Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU) OAB guideline amendment and publication of the OAB clinical care pathway in 2016.MethodsIn this retrospective cohort study, we analyzed data from Optum, a national administrative health and pharmacy claims database, between 2013 and 2018. All adult patients diagnosed with idiopathic OAB were identified by the International Classification of Diseases 9th and 10th Revision codes. Oral OAB therapies were identified using National Drug Codes, while third‐line therapy procedures, onabotulinumtoxinA (BTX), sacral neuromodulation (SNM), and percutaneous tibial nerve stimulation (PTNS), were identified using Current Procedural Terminology (CPT) codes. The study's primary outcome was the annual number of OAB prescriptions filled by pharmacotherapy class and the number of minimally invasive therapies performed during the study period. The secondary outcome was the association between OAB therapy utilization and various clinical and sociodemographic factors. Patterns of care were analyzed from 2013 to 2018, and initial treatment with each therapy was collected, excluding repeat procedures from the analysis.Results1 825 782 patients were included in the study. The mean age was 61.1 ± 16.7 years, and 1 071 420 patients were female (58.7%). The number of new OAB diagnoses increased by 369% from 2013 to 2017. During the 6‐year study period, 347 052 (19%) patients were treated with oral and/or third‐line therapies. The overall number of oral medications prescribed peaked in 2016, followed by a 17% decline between 2016 and 2018. In 2013, the two most prescribed oral medications were oxybutynin (46%) and solifenacin (31.8%). By 2018, mirabegron (18.5%) surpassed solifenacin (16.5%), with oxybutynin still accounting for most prescriptions written (55%). Eighty percent of all initial mirabegron prescriptions were filled by patients over the age of 65. The rate of third‐line therapy procedures almost doubled between 2013 and 2018 (9–17 procedures per 1000 OAB patients, p < 0.001).ConclusionsFollowing the publication of the first OAB guidelines, there was an increase in OAB diagnoses, followed by a decrease in anticholinergic medication use, and a rise in beta‐3 agonist utilization in patients over 65 years old. Additionally, there was greater adoption of third‐line OAB therapies. These trends indicate that OAB therapy guidelines and clinical practice pathways may influence treatment patterns. Given the recent publication of the OAB guidelines, further studies are necessary to assess their impact on therapy utilization patterns.

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Yearly Trends of Overactive Bladder Medication Usage

Cited by 14 publications

References 24 publications

Adverse Events for Overactive Bladder Medications From a Public Federal Database

Adverse Events for Overactive Bladder Medications From a Public Federal Database

Clinical preferences and treatment attitudes among urologists, gynecologists, and geriatricians: An independent online questionnaire survey for comparison of treatment choices in the management of overactive bladder

Trends in Overactive Bladder Therapy: Associations Between Clinical Care Pathways, Practice Guidelines, and Therapy Utilization Patterns

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