A recent study analyzed shifts in patient preferences for third-line therapies for overactive bladder (OAB). Researchers compared established options like onabotulinumtoxin-A injections (BTX-A), percutaneous tibial nerve stimulation (PTNS), and sacral neuromodulation (SNM) with the newly introduced implantable tibial nerve stimulator (ITNS). A survey of 485 adults with OAB symptoms revealed that, before ITNS was introduced, the most preferred therapies were BTX-A (28%) and PTNS (27%). Upon introducing ITNS, 19.2% of participants ranked it as their first choice, leading to a decline in preference for BTX-A, SNM, and PTNS. Notably, participants originally favoring PTNS or SNM showed the most significant interest shift toward ITNS, indicating that ITNS has the potential to attract patients who would not have pursued current third-line therapies.

Participants with concurrent stress urinary incontinence symptoms or prior experience with third-line therapies were more likely to stick with guideline-approved therapies rather than choose ITNS. The results suggest that ITNS may cater to a specific subset of the OAB population who seek alternative neuromodulation options. However, its adoption will depend on factors such as cost, insurance coverage, provider recommendations, and patient-specific factors.

Reference: Kapur A, Aalami Harandi A, Hartman-Kenzler J, Kim J. Shifts in patient preference of third-line overactive bladder therapy after introduction of the implantable tibial nerve stimulator. Neurourol Urodyn. 2024;43(4):959-966. doi: 10.1002/nau.25421.