Whitney Clearwater1, Farzaan Kassam2, Arshia Aalami Harandi3, Christopher F Tenggardjaja4, Nitya Abraham5. 1. Department of Obstetrics & Gynecology and Women's Health, Division of Female Pelvic Medicine and Reconstructive Surgery, Montefiore Medical Center / Albert Einstein College of Medicine, 1250 Waters Place, Tower Two, 9th floor, Bronx, NY, 10461, USA. 2. Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Place, Tower 1 PH, Bronx, NY, 10461, USA. 3. Albert Einstein College of Medicine, 1300 Morris Park Ave, Bronx, NY, 10461, USA. 4. Female Pelvic Medicine and Reconstructive Surgery, Department of Urology, Kaiser Permanente Los Angeles Medical Center, Sunset Blvd, Los Angeles, CA, USA. 5. Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Place, Tower 1 PH, Bronx, NY, 10461, USA. nabraham@montefiore.org.
Abstract
PURPOSE OF REVIEW: To evaluate recent literature on combination and novel pharmacologic therapies for overactive bladder (OAB). RECENT FINDINGS: Combination therapies demonstrating greater efficacy than monotherapy include combination anticholinergics, anticholinergic plus β-3 agonist, and anticholinergic with behavioral modification, percutaneous tibial nerve stimulation, or sacral neuromodulation. Promising novel therapies include new bladder selective anticholinergics, new β-3 agonists, and gabapentin. OAB is a symptom complex caused by dysfunction in the interconnected neural, muscular, and urothelial systems that control micturition. Although several therapeutic targets and treatment options exist, complete resolution is not always achieved, discontinuation rate for medical therapy is high, and few patients subsequently progress to third-line treatment options. Recent literature suggests combination therapy diversifying therapeutic targets is more effective than targeting a single pathway and novel treatments targeting additional pathways have promising results.
PURPOSE OF REVIEW: To evaluate recent literature on combination and novel pharmacologic therapies for overactive bladder (OAB). RECENT FINDINGS: Combination therapies demonstrating greater efficacy than monotherapy include combination anticholinergics, anticholinergic plus β-3 agonist, and anticholinergic with behavioral modification, percutaneous tibial nerve stimulation, or sacral neuromodulation. Promising novel therapies include new bladder selective anticholinergics, new β-3 agonists, and gabapentin. OAB is a symptom complex caused by dysfunction in the interconnected neural, muscular, and urothelial systems that control micturition. Although several therapeutic targets and treatment options exist, complete resolution is not always achieved, discontinuation rate for medical therapy is high, and few patients subsequently progress to third-line treatment options. Recent literature suggests combination therapy diversifying therapeutic targets is more effective than targeting a single pathway and novel treatments targeting additional pathways have promising results.
Authors: Dudley Robinson; Con Kelleher; David Staskin; Elizabeth R Mueller; Christian Falconer; Jianye Wang; Arwin Ridder; Matthias Stoelzel; Asha Paireddy; Rob van Maanen; Zalmai Hakimi; Sender Herschorn Journal: Neurourol Urodyn Date: 2017-07-13 Impact factor: 2.696
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