Overactive Bladder (OAB) is a common urological condition, with significant impacts on patients' quality of life and substantial economic implications for the healthcare market. For stakeholders in the pharmaceutical industry - particularly those targeting the urology market - it's crucial to understand the epidemiology, symptoms, treatment options, and market dynamics of OAB.

What is Overactive Bladder (OAB)?

Defined by the International Continence Society (ICS) in 2002, OAB is a storage symptom syndrome categorized by “urgency, with or without urgency urinary incontinence, usually with increased daytime frequency and nocturia.” The condition often limits individuals’ physical and social activities, leading to feelings of social seclusion.

Source: Mayo Clinic

Symptoms

Patients living with OAB may experience the following symptoms:

● Sudden, uncontrollable urges to urinate

● Unintentional loss of urine immediately following an urgent need to urinate (urgency incontinence)

● Urination frequency of eight or more times within 24 hours

● Waking up more than two times in the night to urinate (nocturia)

These symptoms can be a major disruption to everyday life and pose significant challenges to those living with OAB.

Pathophysiology

Historically, detrusor overactivity (DO), either myogenic or neurogenic, was believed to be the root cause of OAB. Recent studies, however, suggest that not all OAB patients show evidence of DO. Emphasis is now being placed on the role of the urothelium, suburothelium, and bladder afferent signaling in the pathogenesis of OAB.

Epidemiology

The global prevalence of OAB is estimated to range from 11.8% to 25%, with similar rates in men and women, and increasing prevalence with age. In the US alone, OAB impacts approximately 35 million people, highlighting the vast demand for effective treatments in the public health sphere.

Treatment Options

Behavioral therapies

Behavioral interventions remain the primary management approach for OAB and include strategies such as pelvic floor muscle exercises (Kegel exercises), biofeedback, maintaining a healthy weight, scheduled toilet trips, intermittent catheterization, and absorbent pads, among others.

Medications

Early efforts were focused on blocking muscarinic receptor (listed on the left), and drugs were developed in the early 2000. These drugs include Solifenacin (VESIcare), Darifenacin (Enablex), Tolterodine (Detrol), Oxybutynin (Ditropan XL), Trospium, and Fesoterodine (Toviaz). Vibegron and Mirabegron activate the beta3 adrenergic receptors, leading to the relaxation of the detrusor muscle and thus more filling of the bladder. Vibegron and Mirabegron were first marketed by UROVANT SCIENCES in 2018 and by ASTELLAS PHARMA in 2011 respectively.

Modified from Urovant Science, who developed Vibegron.

Injections & Nerve Stimulations

In more severe cases, injections like onabotulinumtoxinA (Botox) and nerve stimulation treatments like sacral nerve stimulation and percutaneous tibial nerve stimulation (PTNS) have shown to be effective.

Surgery

Surgical intervention is also an option for patients who do not respond to other therapies and treatments.

Market Overview

OAB is not only an issue of public health but also one of economic impact. A recent systematic literature review in the US estimated that the average per-person OAB-specific healthcare costs ranged from $656 to $860 (2016 USD). Aggregate total expenditures associated with OAB were estimated between $1.8 and $3.9 billion (2004 USD) annually, translating to approximately $2.4 to $5.2 billion when inflated to 2018 USD. These costs do not even account for indirect costs or those associated with treating comorbidities, further underlining the significant economic burden OAB poses.

Conclusion

At Unibest, we strive to partner with global pharmaceutical companies to develop solutions and manufacture products that directly address these needs and improve the lives of those living with conditions like OAB. As stakeholders in the pharmaceutical industry, let's collectively address this challenge and make meaningful strides towards better health and quality of life for patients worldwide.

If you are interested in developing generic Vibegron, check out our high quality intermediates:

- CAS No, 494224-44-1

- CAS No. 1421271-01-3

- CAS No. 1190392-22-3

Reference

List of 7 Overactive Bladder Medications Compared - Drugs.com

Overactive bladder - Symptoms and causes - Mayo Clinic

OAB Overview Monograph | Urovant Medical Affairs