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Real-world onabotulinumtoxinA treatment patterns in patients with overactive bladder
Bilal Chughtai1, Christine N Ricker2, Ryan J Boldt2
1Department of Urology, Weill Cornell Medicine, New York, New York, USA.
Neurourology and Urodynamics
|December 27, 2023
Summary
Overactive bladder (OAB) treatment with onabotulinumtoxinA is frequently discontinued early. Most patients who stop treatment do not pursue alternative therapies, indicating an unmet need.
Area of Science:
- Urology
- Pharmacology
- Health Services Research
Background:
- Overactive bladder (OAB) significantly impacts quality of life.
- Third-line treatment patterns for OAB, particularly onabotulinumtoxinA, are not well-characterized.
- Understanding treatment utilization and discontinuation is crucial for addressing unmet needs in OAB management.
Purpose of the Study:
- To analyze utilization patterns of onabotulinumtoxinA for OAB.
- To investigate discontinuation rates and subsequent treatment choices.
- To identify the unmet needs in OAB therapeutic options.
Main Methods:
- Retrospective analysis of deidentified administrative claims data (2009-2021).
- Inclusion of patients with OAB initiating onabotulinumtoxinA between 2015-2017.
- Evaluation of treatment patterns over 18 months pre-treatment and at least 36 months post-treatment.
Main Results:
- 21.4% of patients continued onabotulinumtoxinA, with 57% receiving ≥5 treatments.
- 78.6% discontinued treatment, with 84% receiving ≤2 treatments.
- Medication use declined similarly in both groups; sacral neuromodulation was more common in discontinuers (7%) than continuers (3%).
Conclusions:
- Early discontinuation of onabotulinumtoxinA for OAB is prevalent.
- Most patients discontinuing onabotulinumtoxinA do not receive alternative treatments.
- Opportunities exist to educate patients on alternative OAB treatment options.
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