E-Posters-10221

10221_Wolff

Pdf Summary

This study aimed to determine how quickly patients with refractory overactive bladder (OAB) progress to third-line therapy. The current treatment algorithm for OAB recommends behavioral therapies as first-line treatment, followed by medications as second-line and intradetrusor onabotulinum injections (botox), sacral neuromodulation (SNM), and percutaneous tibial nerve stimulation (PTNS) as third-line therapy. However, it is hypothesized that in practice, most women take more than 6 months to undergo third-line therapy after trying medications. <br /><br />The study used a nationwide cohort of adult females with non-neurogenic OAB who underwent third-line therapy between 2013 and 2015. The researchers analyzed data from the MarketScan Commercial and Medicare Supplemental Database, which includes inpatient, outpatient, and prescription drug claims. The inclusion criteria were women with two years of continuous enrollment prior to third-line therapy, and the exclusion criteria were women with neurologic disease and no OAB medication claims. <br /><br />The results showed that 89% of privately-insured adult women with OAB who received third-line therapy did so more than 6 months after starting OAB medications. Additionally, 25% of women went more than 12 months between stopping OAB medications and undergoing third-line therapy. These findings suggest that there is an opportunity to provide symptomatic relief more quickly for many refractory OAB patients. <br /><br />The study also compared women who received third-line therapy one to six months after starting OAB medications (guideline-concordant) to those who received third-line therapy after more than 6 months. There were several significant differences in factors such as age, comorbidities, advanced evaluation prior to third-line treatment, and type of third-line treatment. <br /><br />In conclusion, this study found that most women with refractory OAB undergo third-line therapy more than 6 months after starting OAB medications. There is an opportunity to provide faster relief for these patients and future research should focus on promoting guideline-concordant care.

Keywords

refractory overactive bladder

third-line therapy

treatment algorithm

medications

botox

sacral neuromodulation

percutaneous tibial nerve stimulation

women

time to third-line therapy

guideline-concordant care