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Discontinuation Rates High in Women Treated With Anticholinergic Medications: Presented at AUGS

By Laura Gater

CHICAGO -- September 9, 2008 -- Discontinuation rates for anticholinergic medications are high, regardless of the class of medication used, according to research presented here at the American Urogynecologic Society 29th Annual Scientific Meeting (AUGS).

Manish Gopal, MD, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania, discussed the results in a presentation on September 4.

To determine overall discontinuation rates for anticholinergic drugs and drug-specific discontinuation rates, Dr. Gopal and colleagues analysed data from the Health Improvement Network, an electronic medical database from the United Kingdom.

The researchers defined an episode of drug therapy as the time from the initial prescription to discontinuation. A class-specific discontinuation rate was also determined for 9 different types or classes of anticholinergic drugs. They used the Kaplan-Meier method to report the overall cumulative incidence of discontinuation.

They identified 49,419 episodes of drug therapy available for analysis in women aged 18 years and older (mean, 63.9) who were prescribed anticholinergic medications between January 1991 and December 31, 2005.

The average number of treatment episodes was 1.6, and 1.5 average drug classes were prescribed per patient.

The overall cumulative incidence of discontinuation increased with duration of prescription use.

The drugs with the shortest median time to discontinuation were tolterodine tartrate and flavoxate, at 4 months for each. The adjusted cumulative incidences of discontinuation after 6 months were 57% for extended release oxybutynin (95% confidence interval [CI], 55.1-59.4), 54% for extended release tolterodine tartrate (95% CI, 52.3-57.7), 71% for oxybutynin (95% CI, 68.4-73.5), and 61% for tolterodine tartrate (95% CI, 59.4-64.3).

By 24 months, the adjusted cumulative incidence of discontinuation was >90% for all 9 drug classes.

The study did not provide any information about causes for drug discontinuation, according to Dr. Gopal. But it did demonstrate that the discontinuation rate for anticholinergic drugs is high.


[Presentation title: Discontinuation Rates in Women Treated With Anticholinergic Medications. Paper 15]

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