An evaluation of the impact of propiverine in daily clinical practice: No difference between elderly and non-elderly patients

Introduction and Objectives: OverActive Bladder (OAB) is 4-fold more prevalent in the elderly than in the non-elderly population. Still, the impact of anticholinergics on OAB symptoms and health-related quality of life (HR-QoL) is not well known in the elderly as these patients are systematically excluded from controlled clinical trials due to their co-morbidities and polymedication. We evaluate the impact of propiverine on symptom control and HRQoL in elderly (age≥70 years) and nonelderly (age<70 years) patients with OAB in the routine daily practice in Belgium. Materials and Methods: An open-label prospective study was conducted by urologists and family practitioners as approved by the relevant Ethics Committee. Patients reporting OAB with or without urge urinary incontinence or mixed urinary incontinence for the first time or who stopped their OAB treatment for at least 1 month were enrolled after written informed consent. All patients were treated with propiverine according to labeling and were to complete a 2-day bladder diary and King Health Questionnaire (KHQ) at baseline, week 3 and 12. The analyses compare the outcomes in patients < 70 and ≥ 70 years. Results: The protocol analysis enrolled a total of 313 patients; 151 (48.2%) were elderly; 28.2% of elderly vs. 17.9% of non-elderly patients were male. OAB with urge urinary incontinence was present in 51.7% of elderly vs. 45.7% in non-elderly patients. Bladder diaries for at least 2 visits are available for 156 patients; KHQ for 196 patients. Compared to baseline, micturition frequency decreased by 1.93 (p<0.001), nocturia by 0.8 (p<0.001), urgency by 3.11 (p<0.001) and incontinence episodes by 1.77 (p<0.001); voided volume increased by 25 mL (p<0.001), without difference between age groups. There was clinically significant improvement for all KHQ-domains without difference between age groups. ADRs, all non-serious, occurred in 7.7% of patients and were equally distributed over both age groups. For both age groups, physicians and patients rated efficacy and tolerance as good or very good in ca. 90%. Conclusion: Elderly and non-elderly patients with OAB can be equally expected to demonstrate significant improvements on symptoms and HR-QoL upon treatment with propiverine in daily clinical practice.