NE-AUA 2006 Annual Meeting, September 28 - 30, 2006, The Westin Hotel & Rhode Island Convention Center Providence, Rhode Island
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Correlations Between Improvements in Patientsí Most Bothersome Overactive Bladder Symptoms and Patient-Reported Outcomes After Treatment With Tolterodine Extended Release
David A. Gordon, MD1, Marina Brodsky, PhD2, Dale B. Glasser, PhD2, Karin S. Coyne, MPH, PhD3, Zhanna Jumadilova, MD, MBA2, Martin Carlsson, MS2.
1Chesapeake Urology, Owings Mills, MD, USA, 2Pfizer, Inc, New York, NY, USA, 3United BioSource Corporation Center for Health Outcomes Research, Bethesda, MD,

Background: To assess relationships between subjective and objective improvements in treatment responses in patients with bothersome overactive bladder (OAB) symptoms using tolterodine extended release (TER).
Methods: This 12-week, open-label trial of TER included primary care patients with ≥8 micturitions per 24 hours and ≥2 episodes per 3 days of urinary urgency or urinary urge incontinence (UUI). Eligible patients were required to be at least moderately bothered by their most bothersome symptom. The Patient Perception of Bladder Condition (PPBC) assessed patientsí perception of their overall bladder condition. The Overactive Bladder Questionnaire (OAB-q) was used to assess symptom bother and health-related quality of life (HRQL). 3-day bladder diaries, the PPBC, and the OAB-q were completed at baseline and week 12. Spearman's correlation coefficients were used to examine the relationships between objective and subjective measures.
Results: Of the 863 patients, the most bothersome OAB symptom was daytime frequency (30%), nocturnal frequency (28%), UUI (24%), and urgency (18%). TER was associated with marked reductions in median percentage change for patientsí most bothersome symptom: -80% for UUI, -78% for urgency, -40% for nocturnal frequency, and -30% for daytime frequency. 79% of patients had ≥1-point improvement in PPBC. On the OAB-q, most patients experienced improvements exceeding the 10-point minimally important difference for each domain: Symptom Bother, 90%; Coping, 81%; Concern, 85%; Sleep, 78%; Social Interaction, 55%; and Total HRQL, 82%. Week-12 changes in symptoms were significantly correlated with changes in scores on the PPBC and all OAB-q domains (Table). Week-12 changes in PPBC scores were significantly correlated with changes in scores on each OAB-q domain for each most bothersome symptom group (r=-0.33 to -0.66, P<0.0001).
Conclusions: Patients treated with TER showed significant improvements in their most bothersome OAB symptom, PPBC scores, and OAB-q scores. Improvements in patientsí most bothersome OAB symptoms were positively correlated with changes in PPBC and OAB-q, confirming the relevance of these patient-reported outcomes in OAB.


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