Comparative Effectiveness of Anticholinergic Agents for Lower Urinary Tract Symptoms

Journal of Managed Care & Specialty Pharmacy
Ali B GoodsonBrian C Lund

Abstract

Limited data from short-term clinical trials suggest efficacy advantages of solifenacin and fesoterodine over other anticholinergic agents in the treatment of lower urinary tract symptoms. To (a) determine the real-world comparative effectiveness of newer anticholinergic agents for lower urinary tract symptoms, as assessed by 1-year persistence, and (b) identify patient factors independently associated with persistence. We conducted a retrospective cohort study of U.S. veterans initiating newer anticholinergic therapy between October 2007 and August 2015. Multiple log-binomial regression was used to contrast 1-year persistence rates across anticholinergic agents while adjusting for measured confounders. Persistence was selected as a measure of effectiveness because nonpersistence is a common pathway encompassing inefficacy and intolerability, particularly in symptom-driven conditions. A total of 26,775 patients were included, of which 10,386 (38.8%) persisted with anticholinergic therapy at 1 year. Using long-acting tolterodine as the reference agent, superior persistence rates were observed for solifenacin (RR = 1.08, 95% CI = 1.03-1.13) and fesoterodine (RR = 1.25, 95% CI = 1.09-1.43), and a lower rate for short-acting tolter...Continue Reading

References

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Apr 7, 2016·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Hilary J MosherBrian C Lund
Jul 13, 2016·Journal of Neurology·Katarina Ivana TudorJalesh N Panicker

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Citations

Jan 21, 2020·Expert Opinion on Pharmacotherapy·Cecilia QuarracinoSantiago Pérez-Lloret

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