Behavioral Therapy Noninferior to Drug Treatment for Overactive Bladder in Parkinson’s Disease: JAMA
A new study published in the Journal of American Medical Association showed that behavioral therapy is as effective as drug therapy in managing overactive bladder (OAB) symptoms in patients with Parkinson’s disease. These results support considering behavioral therapy as a first-line treatment option in clinical guidelines for urinary symptoms in PD.
The symptoms of OAB in PD might be exacerbated by the negative effects of medication. Exercise-based behavioral treatment for the pelvic floor muscles prevents drug side effects. Thus, to determine if behavioral treatment is superior than solifenacin medication therapy for OAB symptoms in people with Parkinson's disease, this study was carried out.
In 4 US Veterans Affairs health care systems, a 12-week randomized noninferiority experiment comparing behavioral treatment to solifenacin was carried out between 2018 and 2023. In addition to having a Montreal Cognitive Assessment (MOCA) score of 18 or higher (range: 0-30) and an International Consultation on Incontinence Questionnaire OAB module (ICIQ-OAB) symptom score of 7 or higher (range: 0-16; a higher score indicates worse symptoms), eligible participants were diagnosed with PD by a movement disorder neurologist. Following stratification by sex, recruitment site, severity of OAB, and severity of PD motor symptoms, participants were randomized 1:1. Analysis took place between October 2023 and April 2024.
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