Patterns of use of antimuscarinic drugs to treat overactive bladder in Denmark, Sweden, and the United Kingdom

Andrea V. Margulis*, Marie Linder, Alejandro Arana, Anton Pottegård, Ina Anveden Berglind, Christine L. Bui, Nina Sahlertz Kristiansen, Shahram Bahmanyar, Lisa J. McQuay, Willem Jan Atsma, Kwame Appenteng, Milbhor D'Silva, Susana Perez-Gutthann, Jesper Hallas

*Corresponding author for this work

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Abstract

Purpose To describe the use of antimuscarinic drugs to treat overactive bladder (OAB) in Denmark, Sweden, and the United Kingdom (UK). Methods We identified new users of darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium aged 18 years or older from the Danish National Registers (2004±2012), the Swedish National Registers (2006±2012), and UK Clinical Practice Research Datalink (2004±2012). Users were followed until disenrollment, cancer diagnosis, death, or study end. Treatment episodes, identified by linking consecutive prescriptions, were described with respect to duration, drug switch, and drug add-on. Results Mean age of OAB drug users was 66 years in Denmark (n = 72,917) and Sweden (n = 130,944), and 62 years in the UK (n = 119,912); 60% of Danish and Swedish patients and 70% of UK patients were female. In Denmark, of 224,680 treatment episodes, 39% were with solifenacin, and 35% with tolterodine; 2% were with oxybutynin. In Sweden, of 240,141 therapy episodes, 37% were with tolterodine and 35% with solifenacin; 5% were with oxybutynin. In the UK, of 245,800 treatment episodes, 28% were with oxybutynin, 27% with solifenacin, and 26% with tolterodine. In the three countries, 49%-52% of treatment episodes comprised one prescription and over 80% of episodes ended because of no refill; less than 20% ended because of a switch to another antimuscarinic. During the study years, we observed a change in OAB treatment preference from tolterodine to solifenacin. Conclusions In these cohorts, persistence with antimuscarinic drugs was low. By 2012, the preferred drug was solifenacin; oxybutynin use was marginal in Nordic countries compared with the UK.

Original languageEnglish
Article numbere0204456
JournalPLOS ONE
Volume13
Issue number9
Number of pages13
ISSN1932-6203
DOIs
Publication statusPublished - 1. Sep 2018

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Overactive Urinary Bladder
Muscarinic Antagonists
Denmark
bladder
United Kingdom
Sweden
drugs
Pharmaceutical Preparations
Prescriptions
Switches
Scandinavian and Nordic Countries
Scandinavia
Drug Users
Solifenacin Succinate
Tolterodine Tartrate
oxybutynin
death
therapeutics
neoplasms
duration

Cite this

Margulis, Andrea V. ; Linder, Marie ; Arana, Alejandro ; Pottegård, Anton ; Berglind, Ina Anveden ; Bui, Christine L. ; Kristiansen, Nina Sahlertz ; Bahmanyar, Shahram ; McQuay, Lisa J. ; Atsma, Willem Jan ; Appenteng, Kwame ; D'Silva, Milbhor ; Perez-Gutthann, Susana ; Hallas, Jesper. / Patterns of use of antimuscarinic drugs to treat overactive bladder in Denmark, Sweden, and the United Kingdom. In: PLOS ONE. 2018 ; Vol. 13, No. 9.
@article{65fcb55d7cb149478c44556d9ff82f09,
title = "Patterns of use of antimuscarinic drugs to treat overactive bladder in Denmark, Sweden, and the United Kingdom",
abstract = "Purpose To describe the use of antimuscarinic drugs to treat overactive bladder (OAB) in Denmark, Sweden, and the United Kingdom (UK). Methods We identified new users of darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium aged 18 years or older from the Danish National Registers (2004±2012), the Swedish National Registers (2006±2012), and UK Clinical Practice Research Datalink (2004±2012). Users were followed until disenrollment, cancer diagnosis, death, or study end. Treatment episodes, identified by linking consecutive prescriptions, were described with respect to duration, drug switch, and drug add-on. Results Mean age of OAB drug users was 66 years in Denmark (n = 72,917) and Sweden (n = 130,944), and 62 years in the UK (n = 119,912); 60{\%} of Danish and Swedish patients and 70{\%} of UK patients were female. In Denmark, of 224,680 treatment episodes, 39{\%} were with solifenacin, and 35{\%} with tolterodine; 2{\%} were with oxybutynin. In Sweden, of 240,141 therapy episodes, 37{\%} were with tolterodine and 35{\%} with solifenacin; 5{\%} were with oxybutynin. In the UK, of 245,800 treatment episodes, 28{\%} were with oxybutynin, 27{\%} with solifenacin, and 26{\%} with tolterodine. In the three countries, 49{\%}-52{\%} of treatment episodes comprised one prescription and over 80{\%} of episodes ended because of no refill; less than 20{\%} ended because of a switch to another antimuscarinic. During the study years, we observed a change in OAB treatment preference from tolterodine to solifenacin. Conclusions In these cohorts, persistence with antimuscarinic drugs was low. By 2012, the preferred drug was solifenacin; oxybutynin use was marginal in Nordic countries compared with the UK.",
author = "Margulis, {Andrea V.} and Marie Linder and Alejandro Arana and Anton Potteg{\aa}rd and Berglind, {Ina Anveden} and Bui, {Christine L.} and Kristiansen, {Nina Sahlertz} and Shahram Bahmanyar and McQuay, {Lisa J.} and Atsma, {Willem Jan} and Kwame Appenteng and Milbhor D'Silva and Susana Perez-Gutthann and Jesper Hallas",
year = "2018",
month = "9",
day = "1",
doi = "10.1371/journal.pone.0204456",
language = "English",
volume = "13",
journal = "P L o S One",
issn = "1932-6203",
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Margulis, AV, Linder, M, Arana, A, Pottegård, A, Berglind, IA, Bui, CL, Kristiansen, NS, Bahmanyar, S, McQuay, LJ, Atsma, WJ, Appenteng, K, D'Silva, M, Perez-Gutthann, S & Hallas, J 2018, 'Patterns of use of antimuscarinic drugs to treat overactive bladder in Denmark, Sweden, and the United Kingdom', PLOS ONE, vol. 13, no. 9, e0204456. https://doi.org/10.1371/journal.pone.0204456

Patterns of use of antimuscarinic drugs to treat overactive bladder in Denmark, Sweden, and the United Kingdom. / Margulis, Andrea V.; Linder, Marie; Arana, Alejandro; Pottegård, Anton; Berglind, Ina Anveden; Bui, Christine L.; Kristiansen, Nina Sahlertz; Bahmanyar, Shahram; McQuay, Lisa J.; Atsma, Willem Jan; Appenteng, Kwame; D'Silva, Milbhor; Perez-Gutthann, Susana; Hallas, Jesper.

In: PLOS ONE, Vol. 13, No. 9, e0204456, 01.09.2018.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Patterns of use of antimuscarinic drugs to treat overactive bladder in Denmark, Sweden, and the United Kingdom

AU - Margulis, Andrea V.

AU - Linder, Marie

AU - Arana, Alejandro

AU - Pottegård, Anton

AU - Berglind, Ina Anveden

AU - Bui, Christine L.

AU - Kristiansen, Nina Sahlertz

AU - Bahmanyar, Shahram

AU - McQuay, Lisa J.

AU - Atsma, Willem Jan

AU - Appenteng, Kwame

AU - D'Silva, Milbhor

AU - Perez-Gutthann, Susana

AU - Hallas, Jesper

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Purpose To describe the use of antimuscarinic drugs to treat overactive bladder (OAB) in Denmark, Sweden, and the United Kingdom (UK). Methods We identified new users of darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium aged 18 years or older from the Danish National Registers (2004±2012), the Swedish National Registers (2006±2012), and UK Clinical Practice Research Datalink (2004±2012). Users were followed until disenrollment, cancer diagnosis, death, or study end. Treatment episodes, identified by linking consecutive prescriptions, were described with respect to duration, drug switch, and drug add-on. Results Mean age of OAB drug users was 66 years in Denmark (n = 72,917) and Sweden (n = 130,944), and 62 years in the UK (n = 119,912); 60% of Danish and Swedish patients and 70% of UK patients were female. In Denmark, of 224,680 treatment episodes, 39% were with solifenacin, and 35% with tolterodine; 2% were with oxybutynin. In Sweden, of 240,141 therapy episodes, 37% were with tolterodine and 35% with solifenacin; 5% were with oxybutynin. In the UK, of 245,800 treatment episodes, 28% were with oxybutynin, 27% with solifenacin, and 26% with tolterodine. In the three countries, 49%-52% of treatment episodes comprised one prescription and over 80% of episodes ended because of no refill; less than 20% ended because of a switch to another antimuscarinic. During the study years, we observed a change in OAB treatment preference from tolterodine to solifenacin. Conclusions In these cohorts, persistence with antimuscarinic drugs was low. By 2012, the preferred drug was solifenacin; oxybutynin use was marginal in Nordic countries compared with the UK.

AB - Purpose To describe the use of antimuscarinic drugs to treat overactive bladder (OAB) in Denmark, Sweden, and the United Kingdom (UK). Methods We identified new users of darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, and trospium aged 18 years or older from the Danish National Registers (2004±2012), the Swedish National Registers (2006±2012), and UK Clinical Practice Research Datalink (2004±2012). Users were followed until disenrollment, cancer diagnosis, death, or study end. Treatment episodes, identified by linking consecutive prescriptions, were described with respect to duration, drug switch, and drug add-on. Results Mean age of OAB drug users was 66 years in Denmark (n = 72,917) and Sweden (n = 130,944), and 62 years in the UK (n = 119,912); 60% of Danish and Swedish patients and 70% of UK patients were female. In Denmark, of 224,680 treatment episodes, 39% were with solifenacin, and 35% with tolterodine; 2% were with oxybutynin. In Sweden, of 240,141 therapy episodes, 37% were with tolterodine and 35% with solifenacin; 5% were with oxybutynin. In the UK, of 245,800 treatment episodes, 28% were with oxybutynin, 27% with solifenacin, and 26% with tolterodine. In the three countries, 49%-52% of treatment episodes comprised one prescription and over 80% of episodes ended because of no refill; less than 20% ended because of a switch to another antimuscarinic. During the study years, we observed a change in OAB treatment preference from tolterodine to solifenacin. Conclusions In these cohorts, persistence with antimuscarinic drugs was low. By 2012, the preferred drug was solifenacin; oxybutynin use was marginal in Nordic countries compared with the UK.

U2 - 10.1371/journal.pone.0204456

DO - 10.1371/journal.pone.0204456

M3 - Journal article

VL - 13

JO - P L o S One

JF - P L o S One

SN - 1932-6203

IS - 9

M1 - e0204456

ER -