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.CONCLUSION 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. (C) 2013 Elsevier Inc.