Behavioral Therapy Noninferior to Drug Treatment for Overactive Bladder in Parkinson's Disease: JAMA

The behavioral treatment included urge suppression techniques and training for the pelvic floor muscles. Starting at 5 mg per day, solifenacin treatment can be increased to 10 mg per day as necessary. The main result was the 12-week ICIQ-OAB score, which was within a 15% noninferiority margin for all groups. For eight weeks, adverse events were evaluated every two weeks and then again at twelve weeks.

A total of 77 individuals with Parkinson's disease (65 [84%] men; mean [SD] age, 71.3 [8.9] years; mean [SD] years with PD, 6.6 [5.8]) were randomly assigned to either behavioral therapy (n = 36) or medication therapy (n = 41). The trial was finished by 73 individuals (4 dropped out in the drug group). MOCA score (mean [SD], drug, 23.9 [3.1]; behavioral, 24.8 [3.3]) and ICIQ-OAB score (mean [SD], drug, 9.1 [1.7]; behavioral, 8.5 [1.4]) were among the baseline variables that were equal for each group.

Within the a priori noninferiority margin of 15%, ICIQ-OAB scores at 12 weeks post-randomization showed clinically meaningful improvement across groups (mean [SD] score, drug, 5.8 [2.4]; behavioral, 5.5 [2.0]; P =.02). Falls and dry mouth were reported more often in the medication group than in the behavioral group. Overall, the findings of this trial found that behavioral treatment can help PD patients with their OAB symptoms just as well as medication therapy.

Reference:

Vaughan, C. P., Morley, J. F., Lehosit, J., McGwin, G., Muirhead, L., Khakharia, A., Johnson, T. M., 2nd, Evatt, M. L., Sergent, T., Burgio, K. L., & Markland, A. D. (2025). Behavioral compared with drug therapy for overactive bladder symptoms in Parkinson disease: A randomized noninferiority trial: A randomized noninferiority trial. JAMA Neurology. https://doi.org/10.1001/jamaneurol.2025.1904