Impact of solifenacin on resource utilization, work productivity and health utility in overactive bladder patients switching from tolterodine ER

• Published in: Current medical research and opinion Vol. 24; no. 6; pp. 1583 - 1591
• Main Authors: Zinner, Norman, Noe, Les, Rasouliyan, Lawrence, Marshall, Thomas, Seifeldin, Raafat
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01-06-2008; Taylor & Francis; Informa Healthcare
• Subjects: Activities of Daily Living; Activity impairment; Aged; Benzhydryl Compounds - administration & dosage; Benzhydryl Compounds - pharmacology; Benzhydryl Compounds - therapeutic use; Cresols - administration & dosage; Cresols - pharmacology; Cresols - therapeutic use; Delayed-Action Preparations; Female; Health Services - utilization; Humans; Male; Middle Aged; Muscarinic Antagonists - administration & dosage; Muscarinic Antagonists - pharmacology; Muscarinic Antagonists - therapeutic use; Outcome Assessment (Health Care); Overactive bladder; Patient Acceptance of Health Care; Phenylpropanolamine - administration & dosage; Phenylpropanolamine - pharmacology; Phenylpropanolamine - therapeutic use; Quality of Life; Quinuclidines - administration & dosage; Quinuclidines - pharmacology; Quinuclidines - therapeutic use; Resource utilization; Solifenacin; Solifenacin Succinate; Surveys and Questionnaires; Tetrahydroisoquinolines - administration & dosage; Tetrahydroisoquinolines - pharmacology; Tetrahydroisoquinolines - therapeutic use; Tolterodine; Tolterodine Tartrate; Urinary Bladder, Overactive - drug therapy; Urinary Bladder, Overactive - physiopathology; Work productivity
• ISSN: 0300-7995; 1473-4877
• DOI: 10.1185/03007990802081766

ABSTRACT
Objective: Assess changes in resource utilization, work and activity impairment, and health utility among OAB patients continuing to have urgency symptoms with tolterodine ER 4 mg and willing to try solifenacin 5/10 mg.
Research design and methods: This was an open-label, non-comparative, flexible-dosing, multicenter, 12-week study assessing the efficacy and safety of solifenacin 5/10 mg/day. Patients receiving tolterodine ER 4 mg/day for ≥4 weeks but continuing to experience residual urgency symptoms (≥3 urgency episodes/24 h) were enrolled into the study. After a 14-day washout, patients began treatment with solifenacin 5 mg/day with dosing adjustments allowed at Weeks 4 and 8.
Main outcome measures: Outcomes were assessed using the Work Productivity and Activity Impairment Questionnaire – Specific Health Problem (WPAI-SHP), Health Utilities Index (HUI), and a resource utilization questionnaire administered at Pre-Washout and Week 12.
Results: Patients (n = 440) reported significantly fewer physician office visits (p < 0.0001), UTIs (p < 0.0001), and pads/diapers (p = 0.0009) during the study period while receiving solifenacin 5/10 mg/day, compared with the Pre-Washout period when receiving tolterodine ER 4 mg/day. After 12 weeks of treatment with solifenacin 5/10 mg/day, patients reported a reduction in work time missed (p = 0.0017), less impairment while working (p < 0.0001), less overall work impairment (p < 0.0001) and a reduction in activity impairment (p < 0.0001) compared to Pre-Washout. There was no significant difference in health utility scores. Treatment-emergent adverse events were mostly anticholinergic in nature, and were mild to moderate in severity.
Conclusion: Overall, solifenacin 5/10 mg/day improved work productivity, activity participation, and reduced medical care use in OAB patients who continued to have urgency symptoms with tolterodine ER 4 mg/day and wished to switch to solifenacin 5/10 mg. This was an open-label, non-comparative study; therefore, further research is needed to confirm these results.