A review of solifenacin in the treatment of urinary incontinence

Overactive bladder (OAB) is a prevalent condition which has an adverse effect on quality of life. The presence of urgency incontinence confers significant morbidity above and beyond that of OAB sufferers who are continent. The primary treatment for OAB and urgency incontinence is a combination of behavioral measures and antimuscarinic drug therapy. The ideal antimuscarinic agent should effectively relieve the symptoms of OAB, with the minimum of side effects; it should be available as a once-daily sustained release formulation and in dosage strength that allows easy dose titration for the majority of sufferers. Solifenacin succinate was launched in 2005, and has been shown in both short and long term clinical trials to fulfill these requirements. Solifenacin is a competitive M3 receptor antagonist with a long half-life (45–68 hours). It is available in two dosage strengths namely a 5 or 10 mg once-daily tablet. The efficacy and tolerability of solifenacin for the treatment of all symptoms of OAB has been evaluated in a number of large, placebo controlled, randomized trials. Long-term safety, efficacy, tolerability and persistence with treatment have been established in an open label 40 week continuation study

Disease Burden of Overactive Bladder: Quality-of-Life Data Assessed Using ICI-Recommended Instruments

Overactive bladder (OAB) is characterised by the storage symptoms of urgency, with or without urge incontinence, and usually with urinary frequency and nocturia. OAB is a common condition that affects people of all ages within society. It has an estimated prevalence of 16% and is known to adversely affect quality of life (QOL). Assessment of the QOL of patients is important to understanding both the burden of disease and improvement after treatment. In clinical practice, the physician's assessment of the disease burden of OAB has been shown to be inaccurate and non-reproducible. Psychometrically robust self-completion questionnaires provide a valid, reproducible and rapid assessment of patient-reported disease impact that can elicit the impact of symptoms, and they are also useful for the evaluation of the efficacy of an intervention. Many different questionnaires have been developed to assess the QOL impact of OAB. Generic instruments measure very broad aspects of health and are suitable for a wide range of patient groups and general population screening. They can be applied to patients with any medical condition and provide a measure of morbidity but are less sensitive to clinically relevant change in conditions such as OAB. Condition-specific questionnaires offer greater sensitivity and responsiveness to change in the assessment of QOL of specific patient groups. Single-item global assessment questionnaires are useful in conditions such as OAB that have multiple and varied symptoms, and reflect an individual's needs, concerns and values. Patient-derived outcome measures are used in real-world clinical practice, clinical trials, health economic research and healthcare planning.Overactive-bladder, Quality-of-life

Design and validation of a new screening instrument for lower urinary tract dysfunction: The bladder control self-assessment questionnaire (B-SAQ)

Objectives: To develop and validate a short patient self-assessment screening questionnaire: bladder control selfassessment questionnaire (B-SAQ) for the evaluation of lower urinary tract symptoms. This first validation study was undertaken amongst women. Patients and methods: Three hundred twenty-nine women attending general gynaecology and urogynaecology clinics completed both the B-SAQ and Kings Health questionnaire prior to medical consultation, and independent physician assessment of the presence of lower urinary tract symptoms (LUTS) and need for treatment. The psychometric properties of the B-SAQ were subsequently analysed. Results: The B-SAQ was quick and easy to complete, with 89% of respondents completing all items correctly in less than S min. The internal consistency (Cronbach's alpha score 0.90-0.91), criterion validity (Pearson's correlation values of 0.79 and 0.81, p < 0.0001 with the incontinence impact domain of the Kings Health questionnaire), and test-retest reliability of the questionnaire were good. The sensitivity and specificity of the questionnaire to identify patients with bothersome LUTS was 98% and 79%, respectively. Conclusions: LUTS are commonly underreported. Empowering patients to self-assess their bladder symptoms and the need for treatment will improve treatment- seeking behaviour. The B-SAQ is a psychometrically robust, short screening questionnaire that offers patients the ability to assess their bladder symptoms and the bother they cause, and the potential benefit of seeking medical help. (c) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved