Impact of solifenacin on resource utilization, work productivity and health utility in overactive bladder patients switching from tolterodine ER.
OBJECTIVE
Assess changes in resource utilization, work and activity impairment, and health utility among OAB patients continuing to have urgency symptoms with tolterodine ER 4 mg and willing to try solifenacin 5/10 mg.


METHODS
This was an open-label, non-comparative, flexible-dosing, multicenter, 12-week study assessing the efficacy and safety of solifenacin 5/10 mg/day. Patients receiving tolterodine ER 4 mg/day for >/=4 weeks but continuing to experience residual urgency symptoms (>/=3 urgency episodes/24 h) were enrolled into the study. After a 14-day washout, patients began treatment with solifenacin 5 mg/day with dosing adjustments allowed at Weeks 4 and 8.


METHODS
Outcomes were assessed using the Work Productivity and Activity Impairment Questionnaire - Specific Health Problem (WPAI-SHP), Health Utilities Index (HUI), and a resource utilization questionnaire administered at Pre-Washout and Week 12.


RESULTS
Patients (n=440) reported significantly fewer physician office visits (p<0.0001), UTIs (p<0.0001), and pads/diapers (p=0.0009) during the study period while receiving solifenacin 5/10 mg/day, compared with the Pre-Washout period when receiving tolterodine ER 4 mg/day. After 12 weeks of treatment with solifenacin 5/10 mg/day, patients reported a reduction in work time missed (p=0.0017), less impairment while working (p<0.0001), less overall work impairment (p<0.0001) and a reduction in activity impairment (p<0.0001) compared to Pre-Washout. There was no significant difference in health utility scores. Treatment-emergent adverse events were mostly anticholinergic in nature, and were mild to moderate in severity.


CONCLUSIONS
Overall, solifenacin 5/10 mg/day improved work productivity, activity participation, and reduced medical care use in OAB patients who continued to have urgency symptoms with tolterodine ER 4 mg/day and wished to switch to solifenacin 5/10 mg. This was an open-label, non-comparative study; therefore, further research is needed to confirm these results.
Zinner
Norman
N
Western Clinical Research, Torrance, CA, USA. wewedoc@aol.com
Noe
Les
L
Rasouliyan
Lawrence
L
Marshall
Thomas
T
Seifeldin
Raafat
R
D000203:Activities of Daily Living; D000368:Aged; D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D003408:Cresols / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D010665:Phenylpropanolamine / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D011788:Quality of Life; D011812:Quinuclidines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D000069464:Solifenacin Succinate; D011795:Surveys and Questionnaires; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D000068737:Tolterodine Tartrate; D053201:Urinary Bladder, Overactive / Q000188:drug therapy* / Q000503:physiopathology
D001559:Benzhydryl Compounds; D003408:Cresols; D003692:Delayed-Action Preparations; D018727:Muscarinic Antagonists; D011812:Quinuclidines; D044005:Tetrahydroisoquinolines; D010665:Phenylpropanolamine; D000068737:Tolterodine Tartrate; D000069464:Solifenacin Succinate