Treatment Persistence and Adherence with Overactive Bladder Medications in Taiwan: A Retrospective Database Analysis

Area of Science:

• Pharmacology
• Urology
• Real-world evidence

Background:

• Overactive bladder (OAB) management in Taiwan lacks real-world data on treatment persistence, adherence, and fall/fracture outcomes.
• Common OAB treatments include mirabegron and antimuscarinics.

Purpose of the Study:

• To evaluate and compare treatment persistence, adherence, and rates of falls/fractures in Taiwanese patients receiving OAB treatment with mirabegron versus antimuscarinics.

Main Methods:

• A retrospective, longitudinal, observational study using the Taiwanese National Health Insurance Research Database (2012-2018).
• Included patients aged ≥20 years with new OAB index drug prescriptions and continuous enrollment.
• Multivariate Cox proportional hazards analyses assessed associations between treatment groups and outcomes.

Main Results:

• Over 1.9 million patients were analyzed. Mirabegron demonstrated significantly longer time to discontinuation (TTD) and higher proportion of days covered (PDC) compared to antimuscarinics.
• No statistically significant difference was observed in the risk of composite falls/fractures, falls, or fractures between mirabegron and antimuscarinic users.
• Adjusted hazard ratios (aHRs) for discontinuation favored mirabegron (aHR 1.58).

Conclusions:

• Mirabegron offers superior treatment persistence and adherence compared to antimuscarinics for OAB patients in Taiwan.
• Current data show no significant difference in fall or fracture risk between the two treatment groups, though wide confidence intervals preclude definitive conclusions on equivalence.