Efficacy and Safety of Combination Pharmacotherapy for Patients with Overactive Bladder: A Rapid Evidence Assessment

Publication date: Available online 13 August 2019Source: European UrologyAuthor(s): Christian Gratzke, Christopher Chapple, Elizabeth R. Mueller, Dudley Robinson, Catherine Rolland, David Staskin, Matthias Stoelzel, Rob van Maanen, Emad SiddiquiAbstractContextOral pharmacotherapy consisting of antimuscarinics, β3-adrenoreceptor agonists, or combinations of these agents forms the mainstay of overactive bladder (OAB) management.ObjectiveTo evaluate the efficacy and safety of combination therapy in patients with OAB.Evidence acquisitionA literature search was conducted in June 2018 using Embase, MEDLINE, and Cochrane databases via Ovid and relevant congress abstracts. Studies reporting the efficacy/safety of two antimuscarinics or a β3-adrenoreceptor agonist plus an antimuscarinic were included.Evidence synthesisPublications reported on clinical efficacy, safety, and health-related quality of life (HRQoL) for mirabegron (M) plus solifenacin (S) from three 12-wk randomised controlled trials (RCTs)—SYMPHONY, SYNERGY, and BESIDE—and a 12-mo RCT, SYNERGY II. SYMPHONY reported statistically significant improvements in clinical symptoms and HRQoL with combination therapy versus solifenacin 5 mg (S5) and placebo. In SYNERGY, there were consistent improvements in urinary incontinence (UI) episodes/24 h and micturitions/24 h (coprimary endpoints), and in secondary efficacy parameters with mirabegron 25 mg (M25) + S5 and mira...
Source: European Urology - Category: Urology & Nephrology Source Type: research

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ConclusionsThe PRR in studies of OAB is varied and significant. It is clear that it can be affected by factors in study design including type of bladder diary. When designing clinical studies this should be borne in mind. Equally, when attempting to optimise patient care, the benefit of the therapeutic encounter should be remembered.
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
Condition:   Urinary Urgency Incontinence Intervention:   Device: Neuspera Implantable Sacral Nerve Stimulation System Sponsor:   Neuspera Medical, Inc. Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conclusions: This meta-analysis indicated that BTX-A 200U and 300U are more effective than placebo in the treatment of NDO, with minimal, local, and manageable adverse events. Furthermore, BTX-A 300U and 200U could also improve detrusor compliance of IOAB. However, more RCTs would still be necessary to explore the effect of BTX-A on management of UI in NDO and IOAB patients.
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
The sacral neuromodulation market continues to see disruption as Medtronic scores a CE mark for its InterStim Micro neurostimulator and InterStim SureScan MRI leads, clearing the technologies for sale in Europe. InterStim Micro is a rechargeable device that delivers sacral neuromodulation (SNM) therapy to treat overactive bladder (OAB), fecal incontinence (FI) and non-obstructive urinary retention. It is 80% smaller than the existing recharge-free InterStim II neurostimulator and could reduce the need for battery replacement surgeries due to its life of 15 years. It also features Medtronic'sÂ&...
Source: MDDI - Category: Medical Devices Authors: Tags: Business Source Type: news
Medtronic won EU regulatory clearance to introduce its InterStim Micro neurostimulator and InterStim SureScan MRI leads. The devices are used to deliver sacral neuromodulation therapy to treat overactive bladder (OAB), fecal incontinence, and non-obs...
Source: Medgadget - Category: Medical Devices Authors: Tags: Neurology Neurosurgery Radiology Rehab Source Type: blogs
OBJECTIVES: To evaluate the effect of transcutaneous tibial nerve stimulation (TTNS) and transcutaneous parasacral stimulation on the treatment of overactive bladder (OAB) in elderly people and to compare the final results between groups. METHODS: Fifty female volunteers, mean age 68.62 ( ±5.9) years, were randomly allocated into two groups: those receiving TTNS (G1, N=25) and those receiving transcutaneous parasacral stimulation (G2, N=25). The primary outcome was the International Consultation on Incontinence Questionnaire (ICIQ-OAB) score, and secondary outcomes were the Internat ional Consultation on Incontinenc...
Source: Clinics - Category: General Medicine Source Type: research
Bioness, a Valencia, California firm, won European regulatory approval for its StimRouter neuromodulation system to treat fecal incontinence. Previously cleared in the EU as a tool for managing chronic pain and overactive bladder, the new indicati...
Source: Medgadget - Category: Medical Devices Authors: Tags: GI Neurology Neurosurgery Source Type: blogs
Condition:   Overactive Bladder With Urge Urinary Incontinence Interventions:   Drug: URO-902;   Drug: Placebo Sponsor:   Urovant Sciences GmbH Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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