OBJECTIVES: Patients with overactive bladder (OAB) often have trouble perceiving urgency because of difficulties in distinguishing between urgency and desire to void.
Empirical antimuscarinic treatment of patients with frequency only may be reasonable if conservative management has failed. We compared the efficacy of solifenacin in patients with frequency with or without urgency.
MATERIALS AND METHODS: This multicenter, 12-week, open-label, comparative, non-inferiority clinical trial assessed whether the solifenacin efficacy for frequency without urgency is non-inferior to its efficacy for frequency with urgency. All patients had micturition frequency ≥8 voids/day with or without urgency. Primary efficacy variable: daily frequency change at 12 weeks relative to baseline. Secondary efficacy variables: change at 12 weeks relative to baseline in Patients' Perception of Bladder Condition (PPBC), OAB Symptom Score (OABSS), and Benefit, Satisfaction, Willingness to continue (BSW) questionnaire.
RESULTS: Of the 286 enrolled patients, 240 (83.9%) completed the study (without urgency n = 115; with urgency n = 125). Full dataset analysis revealed that the groups without and with urgency exhibited significant reductions in daily micturition frequency of -2.49±0.35 (mean ± standard error) and -2.63±0.37, respectively. The lower limit of the 95% two-sided CI of the comparison of the two group means was -1.14, which is smaller than the -0.8 margin of clinical equivalence. The two groups did not differ in improvement in PPBC, OABSS, or BSW scores. Both tolerated the treatment well.
CONCLUSIONS: It was not possible to verify that the solifenacin efficacy for frequency alone was non-inferior to its efficacy for OAB. Nevertheless, solifenacin tended to be effective for frequency regardless of urgency.
Written by:
Han JY, Lee KS, Park WH, Park CH, Lee JG, Lee JZ, Kim DY, Na YG8 Kwon DD, Choo MS. Are you the author?
Department of Urology, Pusan National University Yangsan Hospital, Yangsan, Korea; Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; Department of Urology, Inha University College of Medicine, Incheon, Korea; Department of Urology, Keimyung University School of Medicine, Daegu, Korea; Department of Urology, Korea University College of Medicine, Seoul, Korea; Department of Urology, Pusan National University Hospital, Busan, Korea; Department of Urology, Catholic University of Daegu School of Medicine, Daegu, Korea; Department of Urology, Chungnam National University School of Medicine, Daejeon, Korea; Department of Urology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Gwangju, Korea; Department of Urology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Reference: PLoS One. 2014 Nov 17;9(11):e112063.
doi: 10.1371/journal.pone.0112063
PubMed Abstract
PMID: 25401784