Combination and Novel Pharmacologic Agents for OAB

Curr Urol Rep. 2022 Jul;23(7):129-141. doi: 10.1007/s11934-022-01097-7. Epub 2022 May 14.

Abstract

Purpose of review: To evaluate recent literature on combination and novel pharmacologic therapies for overactive bladder (OAB).

Recent findings: Combination therapies demonstrating greater efficacy than monotherapy include combination anticholinergics, anticholinergic plus β-3 agonist, and anticholinergic with behavioral modification, percutaneous tibial nerve stimulation, or sacral neuromodulation. Promising novel therapies include new bladder selective anticholinergics, new β-3 agonists, and gabapentin. OAB is a symptom complex caused by dysfunction in the interconnected neural, muscular, and urothelial systems that control micturition. Although several therapeutic targets and treatment options exist, complete resolution is not always achieved, discontinuation rate for medical therapy is high, and few patients subsequently progress to third-line treatment options. Recent literature suggests combination therapy diversifying therapeutic targets is more effective than targeting a single pathway and novel treatments targeting additional pathways have promising results.

Keywords: Combination therapy; Novel therapy; Overactive bladder.

Publication types

  • Review

MeSH terms

  • Cholinergic Antagonists / therapeutic use
  • Electric Stimulation Therapy* / methods
  • Humans
  • Tibial Nerve
  • Urinary Bladder
  • Urinary Bladder, Overactive* / therapy

Substances

  • Cholinergic Antagonists