Risk factors for the failure of antimuscarinic treatment with solifenacin in women with overactive bladder.
OBJECTIVE
To evaluate the outcomes of women treated with Solifenacin 5 mg once a day for overactive bladder (OAB) to identify the factors associated with the risk of treatment failure.


METHODS
Women with OAB symptoms for at least 3 months were considered for this study. At visit 0, patients received a 3-day voiding diary. Eligibility was determined at visit 1, 2 weeks later, on the basis of the results recorded in the 3-day voiding diary. To be included, patients had to have experienced at least 3 episodes of urgency during the 3-day voiding diary period. Eligible women received a 12-week antimuscarinic therapy with oral Solifenacin 5 mg once a day. At the follow-up examination, objective outcomes included changes from baseline in the 3-day voiding diary data. Subjective efficacy was evaluated using the Overactive Bladder Questionnaire Short Form (OABq-SF), the Indevus urgency severity scale (USS) questionnaire, and the Patient Global Impression of Improvement.


RESULTS
A total of 675 (69.3%) women met the inclusion criteria and were directed to Solifenacin therapy. After a 12-week treatment, 632 (93.6%) women were assessed for office evaluation, and 101 (16%) patients were considered as nonresponders. The antimuscarinics were effective both in terms of improvement of questionnaires scores and in terms of reduction of episodes of urgency/24 hour (P <.0001). In multivariable analysis, the number of episodes of urgency/24 hour, baseline OABq-SF symptom severity score, and baseline USS were independent predictors of Solifenacin failure.


CONCLUSIONS
Some markers of OAB severity, such as the higher number of episodes of urgency/24 hour and the higher OABq-SF symptom severity score and USS at baseline, were associated with a lower therapeutic efficacy of Solifenacin.
Department of Obstetrics and Gynecology, University of Insubria, Varese, Italy. Electronic address: mauserati@hotmail.com.
Maurizio
M
Serati
Andrea
A
Braga
Gabriele
G
Siesto
Paola
P
Sorice
Elena
E
Cattoni
Stefano
S
Uccella
Antonella
A
Cromi
Stefano
S
Salvatore
Fabio
F
Ghezzi
D000368:Aged; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D018727:Muscarinic Antagonists / Q000008:administration & dosage*; D011446:Prospective Studies; D011788:Quality of Life; D011812:Quinuclidines / Q000008:administration & dosage*; D012307:Risk Factors; D000069464:Solifenacin Succinate; D011795:Surveys and Questionnaires; D044005:Tetrahydroisoquinolines / Q000008:administration & dosage*; D013997:Time Factors; D017211:Treatment Failure; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D014554:Urination
D018727:Muscarinic Antagonists; D011812:Quinuclidines; D044005:Tetrahydroisoquinolines; D000069464:Solifenacin Succinate