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Does gabapentin impact response to anticholinergics for overactive bladder?

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Abstract

Introduction and hypothesis

It is unknown whether gabapentin modulates the therapeutic effect of anticholinergics (AC) in patients with overactive bladder. We hypothesized that pre-existing gabapentin use would improve response rates in these patients.

Methods

Female patients treated with AC between 2010–2018 were identified. Data were collected on gabapentin use, indication, dose and duration of use as well as demographic and clinical characteristics. Patients were stratified by those that only took AC and those that took both AC and gabapentin (“combination therapy”). Response was determined through chart review. Descriptive statistics were expressed as medians and interquartile ranges (IQR). Pairwise analysis was performed using Wilcoxon rank-sum. Multivariable logistic regression was used to identify independent variables predicting response. A subgroup analysis was performed in patients with chronic pain disorders.

Results

Seven hundred fifty-six subjects met all criteria; 16.5% (n = 125) were on combination therapy. Those taking gabapentin were more likely to have chronic (49.6% vs. 22.5%, p < 0.001) or neuropathic pain (25.6% vs. 9.4%, p < 0.001) and to use narcotics (41.6% vs. 15.5%, p < 0.001). Patients taking combination therapy were not more likely to improve compared to patients taking AC alone (41.6% vs. 47.7%, p = 0.211), which persisted after adjusting for confounders (aOR = 1.02, 95% CI: 0.63–1.65). In the 182 patients with chronic pain, those receiving combination therapy were more likely to respond than those taking AC alone (35.2% vs. 21.9%, p = 0.0015), although this did not persist after adjusting for confounders (aOR = 1.15, 95% CI: 0.70–1.90).

Conclusions

Pre-existing gabapentin use does not seem to influence response to AC in patients with overactive bladder.

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Authors and Affiliations

  1. Division of Female Pelvic Medicine and Reconstructive Surgery, Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA

    Kasey Roberts, Anood Alfahmy & David Sheyn

  2. Division of Female Pelvic Medicine and Reconstructive Surgery, MetroHealth Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Angela Dao & Diana Mitchell

Authors
  1. Kasey Roberts
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  2. Angela Dao
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  3. Anood Alfahmy
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  4. Diana Mitchell
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  5. David Sheyn
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Contributions

K Roberts: Data collection or management, Data analysis, Manuscript writing/editing

A Dao: Data collection or management

A Alfahmy: Data collection or management, Manuscript writing/editing

D Mitchell: Manuscript writing/editing

D Sheyn: Protocol/project development, Data analysis, Manuscript writing/editing

Corresponding author

Correspondence to Kasey Roberts.

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Conflicts of interest

The authors declare that they have no conflict of interest. However, David Sheyn has received funding for research support from Renalis and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. All other authors have no disclosures or additional sources of funding.

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Meetings

This work was presented as an e-poster at the AUGS PFD Week 10/12/21–10/15/21 (Phoenix, AZ).

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Roberts, K., Dao, A., Alfahmy, A. et al. Does gabapentin impact response to anticholinergics for overactive bladder?. Int Urogynecol J 33, 2501–2506 (2022). https://doi.org/10.1007/s00192-022-05231-4

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  • DOI: https://doi.org/10.1007/s00192-022-05231-4

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