A retrospective study of treatment persistence and adherence to mirabegron versus antimuscarinics, for the treatment of overactive bladder in Spain.
Identifieur interne : 000388 ( Main/Exploration ); précédent : 000387; suivant : 000389A retrospective study of treatment persistence and adherence to mirabegron versus antimuscarinics, for the treatment of overactive bladder in Spain.
Auteurs : Jameel Nazir [Royaume-Uni] ; Zalmai Hakimi [Pays-Bas] ; Florent Guelfucci [Royaume-Uni] ; Amine Khemiri [Tunisie] ; Francis Fatoye [Royaume-Uni] ; Ana María Mora Blázquez [Espagne] ; Marta Hernández González [Espagne]Source :
- BMC urology [ 1471-2490 ] ; 2018.
Descripteurs français
- KwdFr :
- Acétanilides (usage thérapeutique), Adhésion au traitement médicamenteux (MeSH), Adulte d'âge moyen (MeSH), Agents urologiques (usage thérapeutique), Antagonistes muscariniques (usage thérapeutique), Espagne (MeSH), Femelle (MeSH), Humains (MeSH), Modèles des risques proportionnels (MeSH), Modèles linéaires (MeSH), Mâle (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Thiazoles (usage thérapeutique), Vessie hyperactive (traitement médicamenteux), Études longitudinales (MeSH), Études rétrospectives (MeSH).
- MESH :
- traitement médicamenteux : Vessie hyperactive.
- usage thérapeutique : Acétanilides, Agents urologiques, Antagonistes muscariniques, Thiazoles.
- Adhésion au traitement médicamenteux, Adulte d'âge moyen, Espagne, Femelle, Humains, Modèles des risques proportionnels, Modèles linéaires, Mâle, Sujet âgé, Sujet âgé de 80 ans ou plus, Études longitudinales, Études rétrospectives.
- Wicri :
- geographic : Espagne.
English descriptors
- KwdEn :
- Acetanilides (therapeutic use), Aged (MeSH), Aged, 80 and over (MeSH), Female (MeSH), Humans (MeSH), Linear Models (MeSH), Longitudinal Studies (MeSH), Male (MeSH), Medication Adherence (MeSH), Middle Aged (MeSH), Muscarinic Antagonists (therapeutic use), Proportional Hazards Models (MeSH), Retrospective Studies (MeSH), Spain (MeSH), Thiazoles (therapeutic use), Urinary Bladder, Overactive (drug therapy), Urological Agents (therapeutic use).
- MESH :
- chemical , therapeutic use : Acetanilides, Muscarinic Antagonists, Thiazoles, Urological Agents.
- geographic : Spain.
- drug therapy : Urinary Bladder, Overactive.
- Aged, Aged, 80 and over, Female, Humans, Linear Models, Longitudinal Studies, Male, Medication Adherence, Middle Aged, Proportional Hazards Models, Retrospective Studies.
Abstract
BACKGROUND
Persistence on-treatment with antimuscarinics in patients with overactive bladder (OAB) is reported to be sub-optimal. This retrospective, longitudinal, observational cohort study assessed treatment persistence with β
METHODS
Adults who received mirabegron or an antimuscarinic in routine clinical practice (1 June-31 October 2014), were identified from anonymised prescription data within the Spanish Cegedim Electronic Medical Records database. The primary endpoint, treatment persistence (time to treatment discontinuation [TTD] and the proportion of patients remaining on-treatment after 12 months), was unadjusted for potential confounders. Multivariate Cox regression models of persistence, adjusted for baseline characteristics, were used to compare differences in treatment groups. Adjusted subgroup analyses (target OAB drug, age, treatment status and sex) and sensitivity analyses (extending the time used to define treatment discontinuation from 30 days [base-case] to 45, 60 or 90 days without prescription renewal) were also performed.
RESULTS
Overall, 1798 patients received mirabegron (N = 1169) or an antimuscarinic (N = 629); the mean age was 66.42 years. Median TTD was longer for mirabegron versus antimuscarinics (90 vs 56 days) and a higher proportion of patients who received mirabegron were persistent after 12 months (20.2% vs 10.2%); multivariate analyses indicated significantly greater persistence with mirabegron versus antimuscarinics (hazard ratio [HR]: 1.52; 95% confidence interval [CI]: 1.37-1.70; p < 0.001). Significant differences were also observed in subgroup analyses of mirabegron versus individual antimuscarinics (median TTD: 90 vs [range] 28-60 days; HR range: 1.21-2.17; p ≤ 0.013) and in all other subgroups assessed (p < 0.001). Sensitivity analysis showed that the median TTD for mirabegron increased by up to 31 days, and was significantly longer versus antimuscarinics across all adjusted periods (HR range: 1.43-1.53; all p < 0.001).
CONCLUSIONS
Patients with OAB in Spain who received mirabegron experienced longer persistence on-treatment than those who received antimuscarinics and the proportion of patients persistent on-treatment at 12 months with mirabegron was two-times higher versus antimuscarinics. These data may provide strategic insights for clinicians and policy makers involved in the management of OAB.
DOI: 10.1186/s12894-018-0390-z
PubMed: 30180826
PubMed Central: PMC6122705
Affiliations:
- Espagne, Pays-Bas, Royaume-Uni, Tunisie
- Angleterre, Communauté de Madrid, Gouvernorat de Tunis, Grand Londres, Grand Manchester, Hollande-Méridionale
- Leyde, Londres, Madrid, Manchester, Tunis
Links toward previous steps (curation, corpus...)
Le document en format XML
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Jameel.Nazir@astellas.com.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Astellas Pharma Europe Ltd, 2000 Hillswood Drive, Chertsey, KT16 0PS</wicri:regionArea><wicri:noRegion>KT16 0PS</wicri:noRegion></affiliation></author><author><name sortKey="Hakimi, Zalmai" sort="Hakimi, Zalmai" uniqKey="Hakimi Z" first="Zalmai" last="Hakimi">Zalmai Hakimi</name><affiliation wicri:level="3"><nlm:affiliation>Astellas Pharma Europe B.V, Leiden, the Netherlands.</nlm:affiliation><country xml:lang="fr" wicri:curation="lc">Pays-Bas</country><wicri:regionArea>Astellas Pharma Europe B.V, Leiden</wicri:regionArea><placeName><settlement type="city">Leyde</settlement><region nuts="2" type="province">Hollande-Méridionale</region></placeName></affiliation></author><author><name sortKey="Guelfucci, Florent" sort="Guelfucci, Florent" uniqKey="Guelfucci F" first="Florent" last="Guelfucci">Florent Guelfucci</name><affiliation wicri:level="3"><nlm:affiliation>Creativ-Ceutical Ltd., 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Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Astellas Pharma S.A., Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author><author><name sortKey="Gonzalez, Marta Hernandez" sort="Gonzalez, Marta Hernandez" uniqKey="Gonzalez M" first="Marta Hernández" last="González">Marta Hernández González</name><affiliation wicri:level="3"><nlm:affiliation>Astellas Pharma S.A., Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Astellas Pharma S.A., Madrid</wicri:regionArea><placeName><settlement type="city">Madrid</settlement><region nuts="2" type="region">Communauté de Madrid</region></placeName></affiliation></author></analytic><series><title level="j">BMC urology</title><idno type="eISSN">1471-2490</idno><imprint><date when="2018" type="published">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Acetanilides (therapeutic use)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Linear Models (MeSH)</term><term>Longitudinal Studies (MeSH)</term><term>Male (MeSH)</term><term>Medication Adherence (MeSH)</term><term>Middle Aged (MeSH)</term><term>Muscarinic Antagonists (therapeutic use)</term><term>Proportional Hazards Models (MeSH)</term><term>Retrospective Studies (MeSH)</term><term>Spain (MeSH)</term><term>Thiazoles (therapeutic use)</term><term>Urinary Bladder, Overactive (drug therapy)</term><term>Urological Agents (therapeutic use)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Acétanilides (usage thérapeutique)</term><term>Adhésion au traitement médicamenteux (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Agents urologiques (usage thérapeutique)</term><term>Antagonistes muscariniques (usage thérapeutique)</term><term>Espagne (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Modèles des risques proportionnels (MeSH)</term><term>Modèles linéaires (MeSH)</term><term>Mâle (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Thiazoles (usage thérapeutique)</term><term>Vessie hyperactive (traitement médicamenteux)</term><term>Études longitudinales (MeSH)</term><term>Études rétrospectives (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Acetanilides</term><term>Muscarinic Antagonists</term><term>Thiazoles</term><term>Urological Agents</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>Spain</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Urinary Bladder, Overactive</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Vessie hyperactive</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Acétanilides</term><term>Agents urologiques</term><term>Antagonistes muscariniques</term><term>Thiazoles</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Linear Models</term><term>Longitudinal Studies</term><term>Male</term><term>Medication Adherence</term><term>Middle Aged</term><term>Proportional Hazards Models</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adhésion au traitement médicamenteux</term><term>Adulte d'âge moyen</term><term>Espagne</term><term>Femelle</term><term>Humains</term><term>Modèles des risques proportionnels</term><term>Modèles linéaires</term><term>Mâle</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Études longitudinales</term><term>Études rétrospectives</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Espagne</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Persistence on-treatment with antimuscarinics in patients with overactive bladder (OAB) is reported to be sub-optimal. This retrospective, longitudinal, observational cohort study assessed treatment persistence with β</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Adults who received mirabegron or an antimuscarinic in routine clinical practice (1 June-31 October 2014), were identified from anonymised prescription data within the Spanish Cegedim Electronic Medical Records database. The primary endpoint, treatment persistence (time to treatment discontinuation [TTD] and the proportion of patients remaining on-treatment after 12 months), was unadjusted for potential confounders. Multivariate Cox regression models of persistence, adjusted for baseline characteristics, were used to compare differences in treatment groups. Adjusted subgroup analyses (target OAB drug, age, treatment status and sex) and sensitivity analyses (extending the time used to define treatment discontinuation from 30 days [base-case] to 45, 60 or 90 days without prescription renewal) were also performed.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Overall, 1798 patients received mirabegron (N = 1169) or an antimuscarinic (N = 629); the mean age was 66.42 years. Median TTD was longer for mirabegron versus antimuscarinics (90 vs 56 days) and a higher proportion of patients who received mirabegron were persistent after 12 months (20.2% vs 10.2%); multivariate analyses indicated significantly greater persistence with mirabegron versus antimuscarinics (hazard ratio [HR]: 1.52; 95% confidence interval [CI]: 1.37-1.70; p < 0.001). Significant differences were also observed in subgroup analyses of mirabegron versus individual antimuscarinics (median TTD: 90 vs [range] 28-60 days; HR range: 1.21-2.17; p ≤ 0.013) and in all other subgroups assessed (p < 0.001). Sensitivity analysis showed that the median TTD for mirabegron increased by up to 31 days, and was significantly longer versus antimuscarinics across all adjusted periods (HR range: 1.43-1.53; all p < 0.001).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>Patients with OAB in Spain who received mirabegron experienced longer persistence on-treatment than those who received antimuscarinics and the proportion of patients persistent on-treatment at 12 months with mirabegron was two-times higher versus antimuscarinics. These data may provide strategic insights for clinicians and policy makers involved in the management of OAB.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">30180826</PMID><DateCompleted><Year>2018</Year><Month>12</Month><Day>13</Day></DateCompleted><DateRevised><Year>2018</Year><Month>12</Month><Day>13</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1471-2490</ISSN><JournalIssue CitedMedium="Internet"><Volume>18</Volume><Issue>1</Issue><PubDate><Year>2018</Year><Month>Sep</Month><Day>04</Day></PubDate></JournalIssue><Title>BMC urology</Title><ISOAbbreviation>BMC Urol</ISOAbbreviation></Journal><ArticleTitle>A retrospective study of treatment persistence and adherence to mirabegron versus antimuscarinics, for the treatment of overactive bladder in Spain.</ArticleTitle><Pagination><MedlinePgn>76</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s12894-018-0390-z</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Persistence on-treatment with antimuscarinics in patients with overactive bladder (OAB) is reported to be sub-optimal. This retrospective, longitudinal, observational cohort study assessed treatment persistence with β<sub>3</sub>-adrenoceptor agonists (i.e. mirabegron) and antimuscarinics, both classes of OAB pharmacotherapy, in patients with OAB in Spain.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">Adults who received mirabegron or an antimuscarinic in routine clinical practice (1 June-31 October 2014), were identified from anonymised prescription data within the Spanish Cegedim Electronic Medical Records database. The primary endpoint, treatment persistence (time to treatment discontinuation [TTD] and the proportion of patients remaining on-treatment after 12 months), was unadjusted for potential confounders. Multivariate Cox regression models of persistence, adjusted for baseline characteristics, were used to compare differences in treatment groups. Adjusted subgroup analyses (target OAB drug, age, treatment status and sex) and sensitivity analyses (extending the time used to define treatment discontinuation from 30 days [base-case] to 45, 60 or 90 days without prescription renewal) were also performed.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Overall, 1798 patients received mirabegron (N = 1169) or an antimuscarinic (N = 629); the mean age was 66.42 years. Median TTD was longer for mirabegron versus antimuscarinics (90 vs 56 days) and a higher proportion of patients who received mirabegron were persistent after 12 months (20.2% vs 10.2%); multivariate analyses indicated significantly greater persistence with mirabegron versus antimuscarinics (hazard ratio [HR]: 1.52; 95% confidence interval [CI]: 1.37-1.70; p < 0.001). Significant differences were also observed in subgroup analyses of mirabegron versus individual antimuscarinics (median TTD: 90 vs [range] 28-60 days; HR range: 1.21-2.17; p ≤ 0.013) and in all other subgroups assessed (p < 0.001). Sensitivity analysis showed that the median TTD for mirabegron increased by up to 31 days, and was significantly longer versus antimuscarinics across all adjusted periods (HR range: 1.43-1.53; all p < 0.001).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">Patients with OAB in Spain who received mirabegron experienced longer persistence on-treatment than those who received antimuscarinics and the proportion of patients persistent on-treatment at 12 months with mirabegron was two-times higher versus antimuscarinics. These data may provide strategic insights for clinicians and policy makers involved in the management of OAB.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Nazir</LastName><ForeName>Jameel</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Astellas Pharma Europe Ltd, 2000 Hillswood Drive, Chertsey, KT16 0PS, UK. Jameel.Nazir@astellas.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hakimi</LastName><ForeName>Zalmai</ForeName><Initials>Z</Initials><AffiliationInfo><Affiliation>Astellas Pharma Europe B.V, Leiden, the Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guelfucci</LastName><ForeName>Florent</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Creativ-Ceutical Ltd., London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khemiri</LastName><ForeName>Amine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Creativ-Ceutical Ltd., Tunis, Tunisia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Present Address: Keyrus Biopharma, Tunis, Tunisia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fatoye</LastName><ForeName>Francis</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Manchester Metropolitan University, Manchester, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Blázquez</LastName><ForeName>Ana María Mora</ForeName><Initials>AMM</Initials><AffiliationInfo><Affiliation>Astellas Pharma S.A., Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>González</LastName><ForeName>Marta Hernández</ForeName><Initials>MH</Initials><AffiliationInfo><Affiliation>Astellas Pharma S.A., Madrid, Spain.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D003160">Comparative Study</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D064888">Observational Study</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2018</Year><Month>09</Month><Day>04</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMC Urol</MedlineTA><NlmUniqueID>100968571</NlmUniqueID><ISSNLinking>1471-2490</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D000083">Acetanilides</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D018727">Muscarinic Antagonists</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D013844">Thiazoles</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D064804">Urological Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>MVR3JL3B2V</RegistryNumber><NameOfSubstance UI="C520025">mirabegron</NameOfSubstance></Chemical></ChemicalList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000083" MajorTopicYN="N">Acetanilides</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName 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UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016016" MajorTopicYN="N">Proportional Hazards Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013030" MajorTopicYN="N" Type="Geographic">Spain</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013844" MajorTopicYN="N">Thiazoles</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D053201" MajorTopicYN="N">Urinary Bladder, Overactive</DescriptorName><QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D064804" MajorTopicYN="N">Urological Agents</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="Y">therapeutic use</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Antimuscarinics</Keyword><Keyword MajorTopicYN="N">Mirabegron</Keyword><Keyword MajorTopicYN="N">Overactive bladder</Keyword><Keyword MajorTopicYN="N">Treatment persistence</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>02</Month><Day>12</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2018</Year><Month>08</Month><Day>24</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2018</Year><Month>9</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2018</Year><Month>9</Month><Day>6</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2018</Year><Month>12</Month><Day>14</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>epublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">30180826</ArticleId><ArticleId 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