Which Drugs Are Best for Overactive Bladder? From Patients' Expectations to Physicians' Decisions.

In order to help physicians determine which drugs are the best for treating overactive bladder (OAB) symptoms, this review considered three questions: what are the patient's expectations? What information is generated by the Multicriteria Decision Analysis (MCDA) model? What can physicians expect from medical treatments?

A comprehensive literature search was undertaken on these three topics in order to assist physicians regarding the optimum treatment modality for OAB.

Patients' difficulties in reporting symptoms and their expectations of treatment outcomes interfere with the success of treatment. To assist physicians in meeting patients' expectations and to choose the most appropriate treatment, a new approach, recognized by the European Medicines Agency, the MCDA model was used to compare the benefits and safety of OAB treatments.

The MCDA model is useful for comparing the benefit-safety profiles of OAB drugs in order to equip clinicians with information on the drug that might best meet their patient's needs. Flexibly dosed fesoterodine appeared to be most efficacious in resolving urgency and urgency incontinence compared to other drugs, and resolution of urinary urgency appears to be associated with a reduced number of reported adverse events.

International journal of clinical practice. 2020 Nov 29 [Epub ahead of print]

Ian Milsom, Adrian Wagg, Matthias Oelke, Christopher Chapple

Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden., Department of Medicine, University of Alberta, Alberta, Canada., Department of Urology, Pediatric Urology and Urologic Oncology, St. Antonius Hospital, Gronau, Germany., Department of Urology, Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Sheffield, UK.