MaghrebDataLibMedV2, Main, Exploration, bibRecord, 000365

Persistence and Adherence with Mirabegron versus Antimuscarinic Agents in Patients with Overactive Bladder: A Retrospective Observational Study in UK Clinical Practice.

Identifieur interne : 000365 ( Main/Exploration ); précédent : 000364; suivant : 000366

Persistence and Adherence with Mirabegron versus Antimuscarinic Agents in Patients with Overactive Bladder: A Retrospective Observational Study in UK Clinical Practice.

Auteurs : Christopher R. Chapple [Royaume-Uni] ; Jameel Nazir [Royaume-Uni] ; Zalmai Hakimi [Pays-Bas] ; Sally Bowditch [Royaume-Uni] ; Francis Fatoye [Royaume-Uni] ; Florent Guelfucci [France] ; Amine Khemiri [Tunisie] ; Emad Siddiqui [Royaume-Uni] ; Adrian Wagg [Canada]

Source :

European urology [ 1873-7560 ] ; 2017.

RBID : pubmed:28196724

Descripteurs français

English descriptors

KwdEn :
- Acetanilides (administration & dosage), Acetanilides (adverse effects), Adrenergic beta-3 Receptor Agonists (administration & dosage), Adrenergic beta-3 Receptor Agonists (adverse effects), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Chi-Square Distribution (MeSH), Databases, Factual (MeSH), Drug Administration Schedule (MeSH), Female (MeSH), Humans (MeSH), Kaplan-Meier Estimate (MeSH), Logistic Models (MeSH), Longitudinal Studies (MeSH), Male (MeSH), Medication Adherence (MeSH), Middle Aged (MeSH), Muscarinic Antagonists (administration & dosage), Muscarinic Antagonists (adverse effects), Odds Ratio (MeSH), Proportional Hazards Models (MeSH), Retrospective Studies (MeSH), Thiazoles (administration & dosage), Thiazoles (adverse effects), Time Factors (MeSH), Treatment Outcome (MeSH), United Kingdom (MeSH), Urinary Bladder, Overactive (diagnosis), Urinary Bladder, Overactive (drug therapy), Urinary Bladder, Overactive (physiopathology), Urological Agents (administration & dosage), Urological Agents (adverse effects), Young Adult (MeSH).
MESH :
- chemical , administration & dosage : Acetanilides, Adrenergic beta-3 Receptor Agonists, Muscarinic Antagonists, Thiazoles, Urological Agents.
- chemical , adverse effects : Acetanilides, Adrenergic beta-3 Receptor Agonists, Muscarinic Antagonists, Thiazoles, Urological Agents.
- diagnosis : Urinary Bladder, Overactive.
- drug therapy : Urinary Bladder, Overactive.
- physiopathology : Urinary Bladder, Overactive.
- Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Databases, Factual, Drug Administration Schedule, Female, Humans, Kaplan-Meier Estimate, Logistic Models, Longitudinal Studies, Male, Medication Adherence, Middle Aged, Odds Ratio, Proportional Hazards Models, Retrospective Studies, Time Factors, Treatment Outcome, United Kingdom, Young Adult.

Abstract

BACKGROUND

Persistence with antimuscarinic therapy in overactive bladder (OAB) is poor, but may be different for mirabegron, a β

OBJECTIVE

To compare persistence and adherence with mirabegron versus tolterodine extended release (ER) and other antimuscarinics in routine clinical practice over a 12-mo period.

DESIGN, SETTING, AND PARTICIPANTS

Retrospective, longitudinal, observational study of anonymised data from the UK Clinical Practice Research Datalink GOLD database. Eligibility: age ≥18 yr, ≥1 prescription for target OAB drug (between May 1, 2013 and June 29, 2014), and 12-mo continuous enrolment before and after the index prescription date.

INTERVENTIONS

Mirabegron, darifenacin, fesoterodine, flavoxate, oxybutynin ER or immediate-release (IR), propiverine, solifenacin, tolterodine ER or IR, and trospium chloride.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

The primary endpoint was persistence (time to discontinuation). Secondary endpoints included 12-mo persistence rates and adherence (assessed using medication possession ratio, MPR). Cox proportional-hazards regression models and logistic regression models adjusted for potential confounding factors were used to compare cohorts. Analyses were repeated after 1:1 matching.

RESULTS AND LIMITATIONS

The study population included 21996 eligible patients. In the unmatched analysis, the median time-to-discontinuation was significantly longer for mirabegron (169 d, interquartile range [IQR] 41-not reached) compared to tolterodine ER (56 d, IQR 28-254; adjusted hazard ratio [HR] 1.55, 95% confidence interval 1.41-1.71; p<0.0001) and other antimuscarinics (range 30-78 d; adjusted HR range 1.24-2.26, p<0.0001 for all comparisons). The 12-mo persistence rates and MPR were also significantly greater with mirabegron than with all the antimuscarinics. Limitations include the retrospective design, use of prescription records to estimate outcomes, and inability to capture reasons for discontinuation.

CONCLUSIONS

Persistence and adherence were statistically significantly greater with mirabegron than with tolterodine ER and other antimuscarinics prescribed for OAB in the UK.

PATIENT SUMMARY

This study assessed persistence and adherence (or compliance) with medications prescribed for OAB in a large UK population. We found that patients prescribed mirabegron remained on treatment for longer and showed greater adherence than those prescribed traditional antimuscarinics.

DOI: 10.1016/j.eururo.2017.01.037
PubMed: 28196724

Affiliations:

Canada, France, Pays-Bas, Royaume-Uni, Tunisie
Angleterre, Grand Manchester, Hollande-Méridionale, Île-de-France
Leyde, Manchester, Paris

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<term>Acetanilides (adverse effects)</term>
<term>Adrenergic beta-3 Receptor Agonists (administration & dosage)</term>
<term>Adrenergic beta-3 Receptor Agonists (adverse effects)</term>
<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Chi-Square Distribution (MeSH)</term>
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<term>Drug Administration Schedule (MeSH)</term>
<term>Female (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Kaplan-Meier Estimate (MeSH)</term>
<term>Logistic 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 (administration & dosage)</term>
<term>Muscarinic Antagonists (adverse effects)</term>
<term>Odds Ratio (MeSH)</term>
<term>Proportional Hazards Models (MeSH)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Thiazoles (administration & dosage)</term>
<term>Thiazoles (adverse effects)</term>
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<term>Acétanilides (effets indésirables)</term>
<term>Adhésion au traitement médicamenteux (MeSH)</term>
<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Agents urologiques (administration et posologie)</term>
<term>Agents urologiques (effets indésirables)</term>
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<term>Agonistes des récepteurs bêta-3 adrénergiques (effets indésirables)</term>
<term>Antagonistes muscariniques (administration et posologie)</term>
<term>Antagonistes muscariniques (effets indésirables)</term>
<term>Bases de données factuelles (MeSH)</term>
<term>Calendrier d'administration des médicaments (MeSH)</term>
<term>Estimation de Kaplan-Meier (MeSH)</term>
<term>Facteurs temps (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Jeune adulte (MeSH)</term>
<term>Loi du khi-deux (MeSH)</term>
<term>Modèles des risques proportionnels (MeSH)</term>
<term>Modèles logistiques (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Odds ratio (MeSH)</term>
<term>Royaume-Uni (MeSH)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Sujet âgé de 80 ans ou plus (MeSH)</term>
<term>Thiazoles (administration et posologie)</term>
<term>Thiazoles (effets indésirables)</term>
<term>Vessie hyperactive (diagnostic)</term>
<term>Vessie hyperactive (physiopathologie)</term>
<term>Vessie hyperactive (traitement médicamenteux)</term>
<term>Études longitudinales (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
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<term>Adrenergic beta-3 Receptor Agonists</term>
<term>Muscarinic Antagonists</term>
<term>Thiazoles</term>
<term>Urological Agents</term>
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<term>Adrenergic beta-3 Receptor Agonists</term>
<term>Muscarinic Antagonists</term>
<term>Thiazoles</term>
<term>Urological Agents</term>
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<term>Agents urologiques</term>
<term>Agonistes des récepteurs bêta-3 adrénergiques</term>
<term>Antagonistes muscariniques</term>
<term>Thiazoles</term>
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<keywords scheme="MESH" qualifier="diagnostic" xml:lang="fr"><term>Vessie hyperactive</term>
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<term>Agents urologiques</term>
<term>Agonistes des récepteurs bêta-3 adrénergiques</term>
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</keywords>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Chi-Square Distribution</term>
<term>Databases, Factual</term>
<term>Drug Administration Schedule</term>
<term>Female</term>
<term>Humans</term>
<term>Kaplan-Meier Estimate</term>
<term>Logistic Models</term>
<term>Longitudinal Studies</term>
<term>Male</term>
<term>Medication Adherence</term>
<term>Middle Aged</term>
<term>Odds Ratio</term>
<term>Proportional Hazards Models</term>
<term>Retrospective Studies</term>
<term>Time Factors</term>
<term>Treatment Outcome</term>
<term>United Kingdom</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adhésion au traitement médicamenteux</term>
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Bases de données factuelles</term>
<term>Calendrier d'administration des médicaments</term>
<term>Estimation de Kaplan-Meier</term>
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<term>Femelle</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Loi du khi-deux</term>
<term>Modèles des risques proportionnels</term>
<term>Modèles logistiques</term>
<term>Mâle</term>
<term>Odds ratio</term>
<term>Royaume-Uni</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Études longitudinales</term>
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<front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b>
</p>
<p>Persistence with antimuscarinic therapy in overactive bladder (OAB) is poor, but may be different for mirabegron, a β</p>
</div>
<div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b>
</p>
<p>To compare persistence and adherence with mirabegron versus tolterodine extended release (ER) and other antimuscarinics in routine clinical practice over a 12-mo period.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>DESIGN, SETTING, AND PARTICIPANTS</b>
</p>
<p>Retrospective, longitudinal, observational study of anonymised data from the UK Clinical Practice Research Datalink GOLD database. Eligibility: age ≥18 yr, ≥1 prescription for target OAB drug (between May 1, 2013 and June 29, 2014), and 12-mo continuous enrolment before and after the index prescription date.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>INTERVENTIONS</b>
</p>
<p>Mirabegron, darifenacin, fesoterodine, flavoxate, oxybutynin ER or immediate-release (IR), propiverine, solifenacin, tolterodine ER or IR, and trospium chloride.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS</b>
</p>
<p>The primary endpoint was persistence (time to discontinuation). Secondary endpoints included 12-mo persistence rates and adherence (assessed using medication possession ratio, MPR). Cox proportional-hazards regression models and logistic regression models adjusted for potential confounding factors were used to compare cohorts. Analyses were repeated after 1:1 matching.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>RESULTS AND LIMITATIONS</b>
</p>
<p>The study population included 21996 eligible patients. In the unmatched analysis, the median time-to-discontinuation was significantly longer for mirabegron (169 d, interquartile range [IQR] 41-not reached) compared to tolterodine ER (56 d, IQR 28-254; adjusted hazard ratio [HR] 1.55, 95% confidence interval 1.41-1.71; p<0.0001) and other antimuscarinics (range 30-78 d; adjusted HR range 1.24-2.26, p<0.0001 for all comparisons). The 12-mo persistence rates and MPR were also significantly greater with mirabegron than with all the antimuscarinics. Limitations include the retrospective design, use of prescription records to estimate outcomes, and inability to capture reasons for discontinuation.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b>
</p>
<p>Persistence and adherence were statistically significantly greater with mirabegron than with tolterodine ER and other antimuscarinics prescribed for OAB in the UK.</p>
</div>
<div type="abstract" xml:lang="en"><p><b>PATIENT SUMMARY</b>
</p>
<p>This study assessed persistence and adherence (or compliance) with medications prescribed for OAB in a large UK population. We found that patients prescribed mirabegron remained on treatment for longer and showed greater adherence than those prescribed traditional antimuscarinics.</p>
</div>
</front>
</TEI>
<affiliations><list><country><li>Canada</li>
<li>France</li>
<li>Pays-Bas</li>
<li>Royaume-Uni</li>
<li>Tunisie</li>
</country>
<region><li>Angleterre</li>
<li>Grand Manchester</li>
<li>Hollande-Méridionale</li>
<li>Île-de-France</li>
</region>
<settlement><li>Leyde</li>
<li>Manchester</li>
<li>Paris</li>
</settlement>
</list>
<tree><country name="Royaume-Uni"><noRegion><name sortKey="Chapple, Christopher R" sort="Chapple, Christopher R" uniqKey="Chapple C" first="Christopher R" last="Chapple">Christopher R. Chapple</name>
</noRegion>
<name sortKey="Bowditch, Sally" sort="Bowditch, Sally" uniqKey="Bowditch S" first="Sally" last="Bowditch">Sally Bowditch</name>
<name sortKey="Fatoye, Francis" sort="Fatoye, Francis" uniqKey="Fatoye F" first="Francis" last="Fatoye">Francis Fatoye</name>
<name sortKey="Nazir, Jameel" sort="Nazir, Jameel" uniqKey="Nazir J" first="Jameel" last="Nazir">Jameel Nazir</name>
<name sortKey="Siddiqui, Emad" sort="Siddiqui, Emad" uniqKey="Siddiqui E" first="Emad" last="Siddiqui">Emad Siddiqui</name>
</country>
<country name="Pays-Bas"><region name="Hollande-Méridionale"><name sortKey="Hakimi, Zalmai" sort="Hakimi, Zalmai" uniqKey="Hakimi Z" first="Zalmai" last="Hakimi">Zalmai Hakimi</name>
</region>
</country>
<country name="France"><region name="Île-de-France"><name sortKey="Guelfucci, Florent" sort="Guelfucci, Florent" uniqKey="Guelfucci F" first="Florent" last="Guelfucci">Florent Guelfucci</name>
</region>
</country>
<country name="Tunisie"><noRegion><name sortKey="Khemiri, Amine" sort="Khemiri, Amine" uniqKey="Khemiri A" first="Amine" last="Khemiri">Amine Khemiri</name>
</noRegion>
</country>
<country name="Canada"><noRegion><name sortKey="Wagg, Adrian" sort="Wagg, Adrian" uniqKey="Wagg A" first="Adrian" last="Wagg">Adrian Wagg</name>
</noRegion>
</country>
</tree>
</affiliations>
</record>

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Persistence and Adherence with Mirabegron versus Antimuscarinic Agents in Patients with Overactive Bladder: A Retrospective Observational Study in UK Clinical Practice.

Persistence and Adherence with Mirabegron versus Antimuscarinic Agents in Patients with Overactive Bladder: A Retrospective Observational Study in UK Clinical Practice.

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