Combination therapy studies of third-line treatments were rare and centered on medication with PTNS .
Combination therapy , with certain first , second , and third-line OAB therapies , appears to be efficacious .
AIMS Overactive bladder ( OAB ) affects over 17 % of the population and significantly effect the health-related quality of life .
The treatments for OAB include first line ( lifestyle modification , pelvic floor muscle training ) , second line ( anticholinergic or beta-3 agonist medications ) , and third line therapies ( intradetrusor botulinum toxin injection , sacral neurostimulation [ SNM ] , or percutaneous tibial nerve stimulation [ PTNS ] ) .
For those with urinary incontinence secondary to OAB , complete continence is the goal of therapy , though cure rates are only 5 % to 40 % .
The use of combination therapies can be employed in refractory OAB , however , the efficacy of pooled modalities is relatively unknown .
Our objective was to determine the volume of data supporting combination therapy in treating OAB .
Mirabegron as Add-On Treatment to Solifenacin in Patients with Incontinent Overactive Bladder and an Inadequate Response to Solifenacin Monotherapy: Responder Analyses and Patient-Reported Outcomes from the BESIDE Study [corrected].
PURPOSE We investigated improvements in overactive bladder and patient reported outcomes in patients with overactive bladder and refractory incontinence treated with mirabegron  50 mg plus solifenacin 5 mg vs solifenacin 5 or 10 mg . MATERIAL S AND METHODS Patients with overactive bladder who were incontinent despite 4 weeks of single-blind daily solifenacin 5 mg were r and omized 1:1:1 to a double-blind daily combination of mirabegron 50 mg/solifenacin 5 mg , or solifenacin 5 or 10 mg for 12 weeks . The mirabegron dose was increased from 25 to 50 mg after week 4 . Symptom bother , health related quality of life and patient perception of bladder condition were assessed by OAB-q ( Overactive Bladder Question naire ) and the PPBC ( Patient Perception of Bladder Condition ) question naire , respectively . Responder rates were based on a 50 % reduction in daily incontinence , zero incontinence episodes and fewer than 8 micturitions per 24 hours with minimal important differences in OAB-q and PPBC . RESULTS Overall 2,174 patients with a median age of 59 years were r and omized , including 727 to the combination , 728 to solifenacin 5 mg and 719 to solifenacin 10 mg . Symptom bother , total health related quality of life and its subscales ( coping , concern and social ) , and PPBC were significantly improved with combination vs solifenacin monotherapy ( p < 0.05 ) . The odds of achieving clinical ly meaningful improvements in incontinence , micturition frequency , symptom bother , health related quality of life and PPBC were significantly higher for combination than solifenacin monotherapy . The odds of becoming continent was 47 % and 28 % higher for combination vs solifenacin 5 and 10 mg ( OR 1.47 , 95 % CI 1.17 - 1.84 , p = 0.001 and OR 1.28 ; 95 % CI 1.02 - 1.61 , p = 0.033 , respectively ) . CONCLUSIONS Significantly more patients on the combination achieved clinical ly meaningful improvements in incontinence and micturition frequency . Improvements were accompanied by similar improvements in PPBC , symptom bother and health related quality of life
Combination therapy studies of third-line treatments were rare and centered on medication with PTNS .
Combination therapy , with certain first , second , and third-line OAB therapies , appears to be efficacious .
AIMS Overactive bladder ( OAB ) affects over 17 % of the population and significantly effect the health-related quality of life .
The treatments for OAB include first line ( lifestyle modification , pelvic floor muscle training ) , second line ( anticholinergic or beta-3 agonist medications ) , and third line therapies ( intradetrusor botulinum toxin injection , sacral neurostimulation [ SNM ] , or percutaneous tibial nerve stimulation [ PTNS ] ) .
For those with urinary incontinence secondary to OAB , complete continence is the goal of therapy , though cure rates are only 5 % to 40 % .
The use of combination therapies can be employed in refractory OAB , however , the efficacy of pooled modalities is relatively unknown .
Our objective was to determine the volume of data supporting combination therapy in treating OAB .