{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:57:00Z","timestamp":1790571420513,"version":"4.1.0"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["LUTS"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Drug treatment for overactive bladder (OAB) is changing, with an increasing share of \u03b23\u2010adrenoceptor agonists relative to anticholinergics, but it is not known how far this change has progressed in older people, who are most vulnerable to the risks of anticholinergics. We examined the use of these drugs in Japan by age and sex, and analyzed changes in anticholinergic burden using a large database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed outpatient prescriptions of two \u03b23\u2010adrenoceptor agonists and six anticholinergics from FY2017 to FY2024, using the sex\u2010 and age\u2010stratified tables of the NDB Open Data of Japan. Dispensed tablets were converted into patient\u2010days, and the \u03b23\u2010adrenoceptor agonist share was calculated. Anticholinergic burden was measured as ACB\u2010weighted prescription volume (patient\u2010days multiplied by the anticholinergic cognitive burden score). Because FY2021\u2013FY2022 was a period of nationwide generic supply disruption, FY2018 and FY2024 were used as endpoints when estimating change over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The \u03b23\u2010adrenoceptor agonist share rose from 36.2% to 64.9%, but anticholinergic use fell only slightly (3.10\u2009\u00d7\u200910\n                      <jats:sup>8<\/jats:sup>\n                      to 2.94\u2009\u00d7\u200910\n                      <jats:sup>8<\/jats:sup>\n                      tablets; \u22125.0%). In FY2024, the \u03b23\u2010adrenoceptor agonist share was higher in men than in women in every age group, and the difference widened with age (+1.2 percentage points at 50\u201354\u2009years and +14.2 at \u2265\u200990\u2009years). ACB\u2010weighted prescription volume was higher in women than in men, and the female\u2010to\u2010male ratio rose with age (1.1 at 65\u201374\u2009years, 1.6 at 75\u201384\u2009years, and 2.8 at \u2265\u200985\u2009years). Between FY2018 and FY2024, prescription volume fell by about 20% at 65\u201374 and 75\u201384\u2009years, but the fall was smallest in women aged \u2265\u200985\u2009years (\u221211.3%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The \u03b23\u2010adrenoceptor agonist share for OAB has continued to increase in Japan, but this change appears slower in older women, in whom anticholinergic exposure remains high.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/luts.70099","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:41:30Z","timestamp":1790570490000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sex Differences in Prescribing Patterns of Anticholinergics and \u03b23\u2010Adrenoceptor Agonists for Overactive Bladder: A Nationwide Study in Japan,\n                    <scp>FY2017<\/scp>\n                    \u2013\n                    <scp>FY2024<\/scp>"],"prefix":"10.1111","volume":"18","author":[{"given":"Toshikazu","family":"Koike","sequence":"first","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7049-3379","authenticated-orcid":false,"given":"Takashi","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"},{"name":"Department of Urology, Graduate School of Medicine Yokohama City University  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-1054-0779","authenticated-orcid":false,"given":"Akihito","family":"Hashizume","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masanobu","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiji","family":"Takamoto","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4433-370X","authenticated-orcid":false,"given":"Hiroki","family":"Ito","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-5487","authenticated-orcid":false,"given":"Teppei","family":"Takeshima","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroji","family":"Uemura","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7449-2015","authenticated-orcid":false,"given":"Kazuhide","family":"Makiyama","sequence":"additional","affiliation":[{"name":"Department of Urology, Graduate School of Medicine Yokohama City University  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1499-546X","authenticated-orcid":false,"given":"Jun\u2010Ichi","family":"Teranishi","sequence":"additional","affiliation":[{"name":"Departments of Urology and Renal Transplantation Yokohama City University Medical Center  Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,27]]},"reference":[{"issue":"7","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/iju.15454","article-title":"Prevalence and Impact on Daily Life of Lower Urinary Tract Symptoms in Japan: Results of the 2023 Japan Community Health Survey (JaCS 2023)","volume":"31","author":"Mitsui T.","year":"2024","journal-title":"International Journal of Urology"},{"issue":"9","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1111\/j.1464-410X.2005.05835.x","article-title":"An Epidemiological Survey of Overactive Bladder Symptoms in Japan","volume":"96","author":"Homma Y.","year":"2005","journal-title":"BJU International"},{"issue":"1","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"20212","DOI":"10.1038\/s41598-020-77223-7","article-title":"The Impact of Smoking on Male Lower Urinary Tract Symptoms (LUTS)","volume":"10","author":"Kawahara T.","year":"2020","journal-title":"Scientific Reports"},{"issue":"12","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1111\/iju.14357","article-title":"Impact of Smoking Habit on Overactive Bladder Symptoms and Incontinence in Women","volume":"27","author":"Kawahara T.","year":"2020","journal-title":"International Journal of Urology"},{"issue":"17","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1007\/s40265-018-1006-3","article-title":"Vibegron: First Global Approval","volume":"78","author":"Keam S. J.","year":"2018","journal-title":"Drugs"},{"issue":"3","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1001\/jamainternmed.2014.7663","article-title":"Cumulative Use of Strong Anticholinergics and Incident Dementia: A Prospective Cohort Study","volume":"175","author":"Gray S. L.","year":"2015","journal-title":"JAMA Internal Medicine"},{"issue":"8","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1001\/jamainternmed.2019.0677","article-title":"Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case\u2010Control Study","volume":"179","author":"Coupland C. A. C.","year":"2019","journal-title":"JAMA Internal Medicine"},{"issue":"4","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1111\/bju.13068","article-title":"Safety and Efficacy of Mirabegron as \u2018Add\u2010On\u2019 Therapy in Patients With Overactive Bladder Treated With Solifenacin: A Post\u2010Marketing, Open\u2010Label Study in Japan (MILAI Study)","volume":"116","author":"Yamaguchi O.","year":"2015","journal-title":"BJU International"},{"issue":"3","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"311","DOI":"10.2217\/1745509X.4.3.311","article-title":"Impact of Anticholinergics on the Aging Brain: A Review and Practical Application","volume":"4","author":"Boustani M.","year":"2008","journal-title":"Aging Health"},{"issue":"4","key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1517\/14740338.7.4.473","article-title":"Safety of Anticholinergics in Patients With Benign Prostatic Hyperplasia","volume":"7","author":"Athanasopoulos A.","year":"2008","journal-title":"Expert Opinion on Drug Safety"},{"issue":"1","key":"e_1_2_10_12_1","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1111\/j.1464-410X.2006.06574.x","article-title":"The Role of Anticholinergics in Men With Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: A Systematic Review and Meta\u2010Analysis","volume":"99","author":"Blake\u2010James B. T.","year":"2007","journal-title":"BJU International"},{"issue":"3","key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/j.juro.2014.09.091","article-title":"A Randomized Controlled Study of the Efficacy of Tamsulosin Monotherapy and Its Combination With Mirabegron for Overactive Bladder Induced by Benign Prostatic Obstruction","volume":"193","author":"Ichihara K.","year":"2015","journal-title":"Journal of Urology"},{"issue":"7","key":"e_1_2_10_14_1","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1002\/nau.25478","article-title":"Comparative Analysis of Real\u2010World Adherence and Persistence Patterns With Vibegron, Mirabegron, and Anticholinergics in Patients With Overactive Bladder: A Retrospective Claims Study","volume":"43","author":"Chastek B.","year":"2024","journal-title":"Neurourology and Urodynamics"}],"container-title":["LUTS: Lower Urinary Tract Symptoms"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/luts.70099","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/luts.70099","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/luts.70099","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:41:47Z","timestamp":1790570507000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/luts.70099"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,27]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1111\/luts.70099"],"URL":"https:\/\/doi.org\/10.1111\/luts.70099","archive":["Portico"],"relation":{},"ISSN":["1757-5664","1757-5672"],"issn-type":[{"value":"1757-5664","type":"print"},{"value":"1757-5672","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,27]]},"assertion":[{"value":"2026-07-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70099"}}