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Patient‐reported outcomes from SYNERGY,a randomized,double‐blind,multicenter study evaluating combinations of mirabegron and solifenacin compared with monotherapy and placebo in OAB patients
Authors:Dudley Robinson  Con Kelleher  David Staskin  Elizabeth R. Mueller  Christian Falconer  Jianye Wang  Arwin Ridder  Matthias Stoelzel  Asha Paireddy  Rob van Maanen  Zalmai Hakimi  Sender Herschorn
Affiliation:1. King's College Hospital, London, UK;2. Guy's and St Thomas’ Hospital, London, UK;3. Tufts University School of Medicine, Boston, Massachusetts;4. Loyola University Chicago, Stritch School of Medicine, Maywood, Illinois;5. Karolinska Institute, Stockholm, Sweden;6. Beijing Hospital, Beijing, China;7. Astellas Pharma Global Development, Leiden, Netherlands;8. Astellas Pharma Europe Ltd, Surrey, UK;9. Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
Abstract:

Aims

To evaluate patient‐reported outcomes (PROs) of combinations of solifenacin and mirabegron compared with solifenacin and mirabegron monotherapy and with placebo in patients with overactive bladder (OAB) from the SYNERGY trial.

Methods

Following a 4‐week placebo run‐in, period patients (≥18 years) with OAB were randomized 2:2:1:1:1:1 to receive solifenacin 5 mg + mirabegron 25 mg (combination 5 + 25 mg), solifenacin 5 mg + mirabegron 50 mg, (combination 5 + 50 mg), solifenacin 5 mg, mirabegron 25 mg, mirabegron 50 mg or placebo for 12 weeks, followed by a 2‐week washout period. At each visit, PROs related to quality of life, symptom bother, and treatment satisfaction were assessed, including OAB‐q Symptom Bother score, health‐related quality of life (HRQOL) Total score, treatment satisfaction‐visual analogue scale (TS‐VAS), and patient perception of bladder condition (PPBC) questionnaires.

Results

Overall, 3527 patients were randomized into the study, with 3494 receiving double‐blind treatment. At end of treatment (EoT), both combination groups showed greater improvements in OAB‐q Symptom Bother score compared with the monotherapy groups (nominal P < 0.001). Statistically significant improvements in HRQOL Total scores were observed in the combination groups versus monotherapy groups (P ≤ 0.002). For both combination groups, the OAB‐q Symptom Bother score responder rates at EoT were statistically significantly higher versus mirabegron monotherapy (P < 0.05). The mean adjusted changes from baseline to EoT for PPBC were greater in the combination groups compared with monotherapy groups.

Conclusions

PROs showed that combination therapy provided clear improvements and an additive effect for many HRQOL parameters, including OAB‐q Symptom Bother score, HRQOL Total score, and PPBC.
Keywords:β  3‐adrenoceptor agonist  add‐on  combination therapy  mirabegron  overactive bladder  solifenacin
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