Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients

Purpose: To evaluate long-term antimuscarinic drug persistence and its associated characteristics in patients with overactive bladder (OAB) treated with antimuscarinic agents. We also assessed the efficacy and safety of switching from solifenacin to mirabegron in patients refractory to antimuscarini...

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Main Authors: Chung-Cheng Wang, Hann-Chorng Kuo
Format: Article
Language:English
Published: Elsevier 2019-01-01
Series:Journal of the Formosan Medical Association
Online Access:http://www.sciencedirect.com/science/article/pii/S0929664617306514
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spelling doaj-134ca89f47aa4a9f8e57d6cf1a8a12182020-11-25T02:49:35ZengElsevierJournal of the Formosan Medical Association0929-66462019-01-011181279284Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patientsChung-Cheng Wang0Hann-Chorng Kuo1Department of Urology, En Chu Kong Hospital, College of Medicine, National Taiwan University, New Taipei, Taiwan; Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan, TaiwanDepartment of Urology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan; Corresponding author. Department of Urology, Buddhist Tzu Chi General Hospital, 707, Section 3, Chung-Yang Road, Hualien, Taiwan. Fax: +886 3 8560794.Purpose: To evaluate long-term antimuscarinic drug persistence and its associated characteristics in patients with overactive bladder (OAB) treated with antimuscarinic agents. We also assessed the efficacy and safety of switching from solifenacin to mirabegron in patients refractory to antimuscarinic therapy. Methods: In this prospective, open-label, 48-month study, 416 patients (mean age, 70.6 ± 12.4 years) were enrolled. All patients completed the overactive bladder symptom score and urgency severity score questionnaires, along with initial and follow-up uroflowmetry. All patients received antimuscarinic solifenacin 5 mg daily. Mirabegron (25 mg daily) was suggested in patients that were refractory to antimuscarinic therapy or had intolerable side effects. Results: The mean solifenacin persistence was 6.6 ± 8.1 months (range, 0.5–48 months). Only 81 (19.5%) patients had drug persistence of ≥12 months. Male sex, age, cerebral vascular accident, maximum flow rate, and post-void residual were associated with solifenacin persistence in the univariate analysis. Age (odds ratio [OR], 0.14; 95% CI, 0.08–0.21) was the only independent predictor in the multivariate logistic regression. Of the 416 patients, 171 (60.8%) changed from solifenacin to mirabegron for due to the persistence of OAB symptoms. The switch resulted in a significantly longer period of actual OAB pharmacotherapy (9.3 ± 9.2 vs 13.3 ± 9.3 months, p < 0.001). Conclusion: Long-term drug persistence of solifenacin was low during the 2-year follow-up. Age was an independent factor associated with longer drug persistence. Switching from solifenacin to mirabegron was an effective and safe alternative for OAB patients that were refractory to solifenacin treatment. Keywords: Drug persistence, Mirabegron, Muscarinic antagonist, Overactive bladder, Solifenacinhttp://www.sciencedirect.com/science/article/pii/S0929664617306514
collection DOAJ
language English
format Article
sources DOAJ
author Chung-Cheng Wang
Hann-Chorng Kuo
spellingShingle Chung-Cheng Wang
Hann-Chorng Kuo
Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients
Journal of the Formosan Medical Association
author_facet Chung-Cheng Wang
Hann-Chorng Kuo
author_sort Chung-Cheng Wang
title Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients
title_short Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients
title_full Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients
title_fullStr Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients
title_full_unstemmed Factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients
title_sort factors associated with antimuscarinic drug persistence and increasing drug persistence after switching to mirabegron for overactive bladder patients
publisher Elsevier
series Journal of the Formosan Medical Association
issn 0929-6646
publishDate 2019-01-01
description Purpose: To evaluate long-term antimuscarinic drug persistence and its associated characteristics in patients with overactive bladder (OAB) treated with antimuscarinic agents. We also assessed the efficacy and safety of switching from solifenacin to mirabegron in patients refractory to antimuscarinic therapy. Methods: In this prospective, open-label, 48-month study, 416 patients (mean age, 70.6 ± 12.4 years) were enrolled. All patients completed the overactive bladder symptom score and urgency severity score questionnaires, along with initial and follow-up uroflowmetry. All patients received antimuscarinic solifenacin 5 mg daily. Mirabegron (25 mg daily) was suggested in patients that were refractory to antimuscarinic therapy or had intolerable side effects. Results: The mean solifenacin persistence was 6.6 ± 8.1 months (range, 0.5–48 months). Only 81 (19.5%) patients had drug persistence of ≥12 months. Male sex, age, cerebral vascular accident, maximum flow rate, and post-void residual were associated with solifenacin persistence in the univariate analysis. Age (odds ratio [OR], 0.14; 95% CI, 0.08–0.21) was the only independent predictor in the multivariate logistic regression. Of the 416 patients, 171 (60.8%) changed from solifenacin to mirabegron for due to the persistence of OAB symptoms. The switch resulted in a significantly longer period of actual OAB pharmacotherapy (9.3 ± 9.2 vs 13.3 ± 9.3 months, p < 0.001). Conclusion: Long-term drug persistence of solifenacin was low during the 2-year follow-up. Age was an independent factor associated with longer drug persistence. Switching from solifenacin to mirabegron was an effective and safe alternative for OAB patients that were refractory to solifenacin treatment. Keywords: Drug persistence, Mirabegron, Muscarinic antagonist, Overactive bladder, Solifenacin
url http://www.sciencedirect.com/science/article/pii/S0929664617306514
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