AMSTERDAM — A large database study has shown that women with overactive bladders (OABs), tend to stop taking their medication more often than previously thought.
Nearly 46,000 women submitted nearly 800,000.000 claims for medication to treat OAB. The average rate at which drugs were continued to be taken was 49% in 30 days and 34% in 90 days. According to Karin Lifshitz MD, a Tel Aviv Medical Center urologist, only 9% of patients had a prescription within one year after they began taking medication.
Lifshitz stated that it doesn’t matter if you started with an anticholinergic agent or a beta-3 antagonist; treatment cessation is the next likely step in the treatment sequence in an oral abstract session at EAU 2022 Annual Meeting. This abstract was chosen as the best at the meeting.
Lifshitz defined “treatment persistence” by her colleagues as the number of days a patient had access to medication. Nonpersistence was defined as the patient not filling their prescription for at least 90 consecutive days.
In controlled clinical trials, OAB medical therapies have been proven to be effective. However, 1-year persistence rates for anticholinergic drugs have been as low at 25% and for beta-3 agonists, as low as 40%. Lifshitz stated.
Lifshitz used advanced data-mining techniques with her colleagues to determine if real-world data about treatment continuation and treatment order differed from reports. They analyzed data from Israel’s largest healthcare provider for all OAB medicines purchased by women between 2010 and 2020.
The total number of women who purchased OAB medication from OAB was 46,079.
The drug analysis included fesoterodine (8-mg and mirabregon (10mg) in 25- to 50-mg dosages, Mybetriq in 25- and 50 mg doses and oxybutyni (5 mg) in 5- and 10-mg dosing, solifenacin (20mg) in 5- and 10mg, tolterodine (4mg) in 2-, 4-, and 30-mg, respectively, and trospium (30mg) in 15-, 20–, 20-, 30 and 20-, 15-,
Mirabegron (10%), oxybutynin (11%), had the highest 1-year persistence rates compared to all other medications (4%; p .005). Older patients were more likely than younger patients to continue filling their prescriptions.
Researchers also evaluated the time periods before and after mirabegron’s introduction. This drug has been shown to be safe and well-tolerated in comparison with other therapies. Patients were not prescribed the drug after their first prescription.
Jean-Nicola Cornu (MD, PhD), a French invited speaker, stated that the persistence rate revealed by the authors was quite low in comparison to previous studies on the topic.
He pointed out that mirabegron’s persistence was significantly higher than tolterodine and traditional antimuscarinic drugs in an OAB 2017 study, compared to Lifshitz’s low rate.
The inability to include demographic variables that could account for treatment interruptions in database studies may explain part of the variation. Cornu stated that the study did not assess potential factors that could cause treatment interruptions, such as cost of therapy or adverse events.
Internally funded, the study was conducted by. Lifshitz did not disclose any financial relationships. Cornu has financial relationships to multiple pharmaceutical companies.
European Association of Urology (EAU), 2022 Annual Meeting: Abstract a0442. Presented July 3, 2022.
Neil Osterweil is an award-winning journalist in the medical field and a regular contributor to Medscape.
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