Incidence and risk factors of recurrence of overactive bladder symptoms after discontinuation of successful medical treatment

Kim and co-authors conducted a prospective, multi-centre clinical study to identify incidence and risk factors of recurrence after discontinuation of successful antimuscarinic therapy in patients with overactive bladder (OAB). Patients who had antimuscarinic agents for > 12 weeks and showed successful response were included.

Successful response was defined as answering 'benefit' for patient perception of treatment benefit and answer lesser than 3 points in patient's perception of bladder condition (PPBC). The enrolled patients discontinued the antimuscarinics and the recurrence with PPBC and OAB symptom score (OABSS) at 1, 3, 6, and 12 months were evaluated. The primary purpose was to identify the recurrence rate and secondary purpose was to reveal risk factors.

Observations of the study were as follows:

• 441 patients were included in the study and 371 patients completed 6-month follow-up
• Patients showed 1.6 points in PPBC, 2.9 points in OABSS and 1.4 points in IPSS (quality of life) which represented successful response after using antimuscarinics
• Cumulative rates of recurrence were 25.6%, 42.3%, and 52.2% at 1, 3, 6 months, respectively
• Among 177 patients who did not show recurrence at 6 months, 41 patients were followed up and 4 patients of the 41 patients (9.7%) showed recurrence at 12 months
• On univariate and multivariate analyses of recurrence, OAB wet was the risk factor for recurrence after 6 months of discontinuation

The authors concluded that discontinuation of antimuscarinic therapy after successful treatment resulted in high recurrence rate with time and OAB wet was the independent risk factor for recurrence.

Reference: Kim A, et al. Incidence and risk factors of recurrence of overactive bladder symptoms after discontinuation of successful medical treatment. Investig Clin Urol. 2017; 58(1): 42-47.