title: Antimuscarinic persistence patterns in newly treated patients with overactive bladder: a retrospective comparative analysis.
abstract: OBJECTIVE
  Treatment persistence is low in patients with overactive bladder (OAB), but persistence may vary among antimuscarinic agents. This study compared treatment persistence in patients with OAB receiving fesoterodine, solifenacin, or tolterodine as their initial OAB prescription in a routine clinical practice setting.
  
  
  METHODS
  This retrospective study used medical records from primary healthcare centers in three locations in Spain; records from patients aged ≥18 years with a diagnosis of OAB who initiated antimuscarinic treatment for OAB (fesoterodine, tolterodine, or solifenacin) were included. The first prescription of one of the OAB study medications was considered the index date; patients were followed for ≥52 weeks. Persistence was estimated using Kaplan-Meier curves and Cox proportional hazard regression models, adjusting for covariates.
  
  
  RESULTS
  A total of 1,971 records of patients (58.3 % women; mean age 70.1 years) initiating treatment with fesoterodine (n = 302), solifenacin (n = 952), or tolterodine (n = 717) were included. Unadjusted mean (±SD) treatment duration was 31.5 ± 17.6 weeks for fesoterodine, 29.9 ± 21.4 for solifenacin and 29.0 ± 21.6 for tolterodine (p = 0.217). At week 52, 35.8 % of fesoterodine-treated patients remained on their initial therapy, versus 31.9 % of solifenacin-treated (hazard ratio [HR], 1.24; 95 % CI, 1.05-1.47; p = 0.011) and 30.9 % of tolterodine-treated (HR = 1.28; 95 % CI, 1.07-1.52; p = 0.006) patients. Findings were consistent when the definition for discontinuation was varied.
  
  
  CONCLUSIONS
  Overall persistence at week 52 was low, but the cumulative probability of persisting with initial therapy was significantly higher for fesoterodine than for solifenacin or tolterodine in clinical practice in Spain.
authors.affiliation: Directorate of Planning, Badalona Serveis Assistencials SA, Calle Gaietà Soler, 6-8 entlo., 08911, Badalona, Barcelona, Spain, asicras@bsa.cat.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sicras-Mainar
authors.forename: Javier
authors.initials: J
authors.lastname: Rejas
authors.forename: Ruth
authors.initials: R
authors.lastname: Navarro-Artieda
authors.forename: Alba
authors.initials: A
authors.lastname: Aguado-Jodar
authors.forename: Amador
authors.initials: A
authors.lastname: Ruiz-Torrejón
authors.forename: Jordi
authors.initials: J
authors.lastname: Ibáñez-Nolla
authors.forename: Marion
authors.initials: M
authors.lastname: Kvasz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use*; D011358:Product Surveillance, Postmarketing; D012189:Retrospective Studies; D053201:Urinary Bladder, Overactive / Q000188:drug therapy*; D016903:Drug Monitoring
chemical_list: D018727:Muscarinic Antagonists