Following the success of the 42nd ICS Annual Meeting in Beijing in 2012, the 43rd ICS Annual Meeting was held in Barcelona, Spain from August 26-30, 2013 as scheduled. The meeting addressed the hot issues in the field of urinary control today. The progress of OAB research at this year’s ICS Annual Meeting, especially in terms of pharmacological treatment, is reported below.
Epidemiological studies of OAB The incidence of OAB is high, with a prevalence of more than 10% in adults over 40 years of age. According to a study conducted in Turkey on the prevalence of lower urinary tract symptoms (LUTS), OAB and urinary incontinence, 71% of the study population reported at least one LUTS, with a prevalence of 56.1% for urinary urgency, frequency and other storage phase symptoms.
Another study showed that the occurrence of OAB symptoms (Figure) was more common in diabetic patients compared to the general population. It is important to note that there are already more than 142 million people with diabetes worldwide, and according to the results of the above study, there will be a higher percentage of diabetic patients with OAB symptoms.
OAB also severely affects the quality of sleep of patients. In addition, despite the high prevalence of OAB, patient awareness of it remains low.
Treatment of OAB Behavioral therapy and pharmacotherapy are the treatment options of choice for patients with OAB.
Behavioral therapy Most women with OAB prefer lifestyle modifications, such as more exercise and dietary modifications, to taking medications. Behavioral therapy can enhance the efficacy of medications. In a study of 643 OAB patients initially treated with the new highly selective bladder M3 receptor antagonist solifenacin, bladder training was shown to enhance the efficacy of drug therapy.
Although several OAB treatment guidelines recommend a 3-month treatment course, this is not sufficient to provide complete symptom relief and improve quality of life, and patients need more long-term behavioral therapy.
Pharmacological treatment M receptor antagonists remain the first line of clinical treatment for OAB. A prospective, multicenter clinical study of women with OAB treated with solifenacin showed that treatment with a flexible dose of solifenacin 5-10 mg improved the total score on the Overactive Bladder Scale (OABSS) and scores for urgency, frequency, nocturia, and urinary incontinence, as well as quality of life.
Another study compared resource utilization, urinary pad use, and patient satisfaction in patients with OAB treated with solifenacin, tolterodine, and trasylolonium. The results showed that overall patient satisfaction with solifenacin treatment was 47.8%, significantly higher than overall patient satisfaction with tolterodine and traslodonium chloride treatment (27.3% and 14.7%, respectively; p < 0.001). Among them, good efficacy, few side effects and ease of use were the most important reasons for patients' satisfaction with solifenacin treatment. The combination of M receptor antagonists with other drugs for OAB is a hot topic of research. A study evaluated the efficacy and safety of tamsulosin in combination with solifenacin in men with OAB with cerebral infarction based on the severity of LUTS. The results showed that tamsulosin combined with solifenacin was more effective in improving LUTS and quality of life in men with OAB with cerebral infarction, with better efficacy in patients with severe symptoms than in those with moderate symptoms. Another study evaluated the efficacy and safety of initial treatment with an alpha1 receptor blocker in combination with an M receptor antagonist. The results showed that the initial combination of solifenacin and tamsulosin rapidly improved the International Prostate Symptom Scale (IPSS) symptom scores and OABSS scores without causing serious adverse effects compared to delayed administration of solifenacin therapy. Therefore, initial combination therapy with solifenacin and tamsulosin is a safe and effective treatment option for patients with benign prostatic hyperplasia (BPH) with OAB.