Overactive Bladder Pharmacotherapy in the Real World: Persistence, Combination Effects, and Comparative Efficacy

Overactive bladder (OAB) is a common and burdensome condition that affects urinary symptoms, sleep, mental well-being, daily functioning, and quality of life. Although several pharmacological options are available, evidence from clinical trials does not always reflect treatment use in routine clinical practice. In real-world settings, persistence may be limited by insufficient symptom relief, adverse events, treatment cost, comorbidities, polypharmacy, or patient preferences.The expanding use of antimuscarinic agents, β3-adrenoceptor agonists, sequential strategies, and combination pharmacotherapy has created a need for clinically relevant comparative evidence. Important questions remain about how long patients continue treatment, which patient characteristics predict persistence, whether combination regimens add meaningful benefit, and how effectiveness varies across healthcare settings and specific patient populations, including older adults, people with multimorbidity, and those with neuro-urological conditions.This Research Topic will bring together clinical, epidemiological, pharmacological, and health-services research examining OAB pharmacotherapy beyond the controlled trial environment. It will focus on evidence that can support personalised treatment selection, improve shared decision-making, and inform practical management strategies for patients with OAB.A particular aim is to show how real-world evidence can complement randomised trials in populations that are often under-represented in them, and how it may shape future clinical guidelines and everyday clinical decision-making.This Research Topic aims to examine the real-world use, effectiveness, safety, and value of pharmacological treatments for OAB, with an emphasis on personalised treatment strategies and specific patient populations. We welcome Original Research, Systematic Reviews, Meta-Analyses, Narrative Reviews, Methods articles, Brief Research Reports, Clinical Trial Protocols, Perspectives, and Opinions addressing themes such as:• Treatment persistence, adherence, discontinuation, switching, and re-initiation• Real-world comparative effectiveness of antimuscarinics and β3-adrenoceptor agonists• Sequential treatment pathways, escalation strategies, and combination therapy• Personalised treatment selection, including predictors of response and persistence• Older adults, and patients with multimorbidity or polypharmacy, including anticholinergic burden and cognitive safety• Neuro-urological conditions (e.g., multiple sclerosis, spinal cord injury, Parkinson's disease, stroke) where relevant• Sex-, age-, and comorbidity-related differences in treatment response• Symptom control, quality of life, patient-reported outcomes, and tolerability• Real-world evidence from electronic health records, claims databases, registries, and cohorts• How real-world evidence can inform guideline development and clinical decision-making• Patient values, preferences, and access to OAB pharmacotherapy• Healthcare resource use and cost-effectiveness• Methodological challenges, including confounding control and outcome definition• Integration of pharmacotherapy with behavioural and conservative treatmentsSubmissions should have a clear connection to OAB pharmacotherapy and present clinically interpretable evidence. Studies on basic pharmacology without a clear clinical or real-world treatment connection are outside the primary scope. Topic editors: Naoki Wada, Marie Carmela Lapitan Source: https://www.frontiersin.org/research-topics/87307/overactive-bladder-pharmacotherapy-in-the-real-world-persistence-combination-effects-and-comparative-efficacy