Urinary Biomarkers and Response to Treatment in Overactive Bladder (OAB): A Systematic Review and Meta-Analysis.
Thiago Khouri, Bruna Matos, Lukas Salles et al.
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In 30 seconds
This systematic review and meta-analysis examined whether urinary biomarkers track treatment response and symptom changes in adults with overactive bladder (OAB). The authors identified prospective clinical studies of established OAB treatments; meta-analysis was limited to nerve growth factor (NGF). Across nine studies reporting NGF data, biomarker levels fell after treatment in both responders and non-responders. Responders had greater biomarker decreases and significantly larger improvements in symptom scores. The authors judged the evidence heterogeneous and limited, while suggesting urinary NGF may have a role in monitoring response.
Key findings
- Across nine studies reporting NGF data, urinary NGF decreased after treatment in both responders and non-responders.
- Responders showed greater biomarker decreases and significantly larger symptom-score improvements than non-responders.
- Evidence for urinary biomarkers in OAB was heterogeneous and limited; meta-analysis was restricted to NGF.
Why it matters
OAB lacks objective diagnostic tests, and symptom questionnaires may be difficult to administer or unreliable for some patients. The reported relationship between falling urinary NGF and symptom improvement raises the possibility of an objective adjunct for monitoring treatment response and distinguishing disease phenotypes, although the current evidence does not establish its clinical utility.
What to keep in mind
The evidence was heterogeneous and limited, and meta-analysis was possible only for NGF; other biomarkers were reported in smaller subsets of studies.