Overactive bladder diagnoses found to increase after guideline publication

An increase in overactive bladder (OAB) diagnoses was seen following publication of the first OAB guideline, and the rate of third-line therapy procedures also increased, according to a study published online Nov. 19 in Neurourology & Urodynamics.

Hodan Mohamud, from the University of Toronto, and colleagues conducted a retrospective cohort study to examine trends in therapy utilization before and after the 2014 American Urological Association/Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction OAB guideline amendment and publication of a clinical care pathway in 2016. Patterns of care were assessed from 2013 to 2018.

The study included 1,825,782 patients (mean age, 61.1 ± 16.7 years). From 2013 to 2017, the researchers found a 369 percent increase in the number of new OAB diagnoses. Nineteen percent of patients were treated with oral and/or third-line therapies during the six-year study period. The number of oral medications prescribed peaked in 2016, then decreased 17 percent by 2018.

The two most prescribed oral medications in 2013 were oxybutynin and solifenacin (46.0 and 31.8 percent, respectively). Mirabegron surpassed solifenacin by 2018 (18.5 versus 16.5 percent), while oxybutynin still accounted for most prescriptions (55 percent). Patients older than 65 years of age filled 80 percent of all initial mirabegron prescriptions. From 2013 to 2018, the rate of third-line therapy procedures nearly doubled (nine to 17 per 1,000 OAB patients).

“These trends suggest that OAB therapy guidelines and clinical practice pathways may influence treatment patterns,” the authors write.

One author disclosed ties to the pharmaceutical industry.

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