Two doses of propiverine ER (30 and 45 mg/d) are available for the treatment of overactive bladder (OAB) syndrome. We have explored factors associated with the initial dosing choice (allocation bias), the decision to adapt dosing (escalation bias) and how dosing relative to other factors affects treatment outcomes. Data from two non-interventional studies of 1335 and 745 OAB patients, respectively, receiving treatment with propiverine, were analyzed post-hoc. Multivariate analysis was applied to identify factors associated with dosing decisions and treatment outcomes. Several parameters were associated with dose choice, escalation to higher dose or treatment outcomes, but only few exhibited a consistent association across both studies. These were younger age for initial dose choice and basal number of urgency and change in incontinence episodes for up-titration. Treatment outcome (difference between values at 12 weeks vs. baseline) for each OAB system was strongly driven by the respective baseline value, whereas no other parameter exhibited a consistent association. Patients starting on the 30 mg dose and escalating to 45 mg after 4 weeks had outcomes comparable with those staying on a starting dose of 30 or 45 mg. We conclude that dose escalation after 4 weeks brings OAB patients with an initially limited improvement to a level seen in initially good responders. Analysis of underlying factors yielded surprisingly little consistent insight.
Journal of clinical medicine. 2021 Jan 15*** epublish ***
Marjan Amiri, Tim Schneider, Matthias Oelke, Sandra Murgas, Martin C Michel
Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, 45130 Essen, Germany., Praxisklinik Urologie Rhein-Ruhr, 45468 Mülheim, Germany., Department of Urology, St. Antonius Hospital, 48599 Gronau, Germany., Apogepha, 01309 Dresden, Germany., Department of Pharmacology, Johannes Gutenberg University, 55131 Mainz, Germany.