Urinary Biomarkers and Response to Treatment in Overactive Bladder (OAB): A Systematic Review and Meta‐Analysis

Introduction Overactive bladder (OAB) is a prevalent symptom‐based syndrome lacking objective diagnostic tests. Urinary biomarkers, particularly nerve growth factor (NGF), have emerged as potential non‐invasive tool for diagnosis and treatment monitoring. Objectives To systematically review and meta‐analyze the association between urinary biomarker with treatment response and symptom score changes in adults with OAB. Methods Prospective clinical studies relating urinary biomarkers to established OAB treatments were identified in eight databases up to May 2024, selected with predefined criteria, assessed with the Newcastle–Ottawa Scale (NOS), and synthesized as percentage mean changes; meta‐analysis was limited to NGF. Results Nine studies carried out NGF data and smaller subsets reported on other biomarkers, showing post‐treatment biomarker reductions in both responders and non‐responders, with greater decreases and significantly larger symptom score improvements in responders. Conclusions Evidence regarding the usefulness of urinary biomarkers in OAB patients is still heterogeneous and limited. Urinary NGF levels decrease during OAB treatment in accordance with symptoms questionnaires scores improvement suggesting that some urinary biomarkers may serve as a useful tool for monitoring treatment response in patients for whom symptom questionnaires cannot be administered or are considered unreliable, contributing in the differentiation of different disease phenotypes.