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Efficacy of Antimuscarinic Therapy for Overactive Bladder With Varying Degrees of Incontinence Severity

2004; Lippincott Williams & Wilkins; Volume: 171; Issue: 2 Linguagem: Inglês

10.1097/01.ju.0000103540.71683.e5

1527-3792

J. Richard Landis, Steve Kaplan, Steve Swift, Eboo Versi,

Urinary Tract Infections Management

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Feb 2004Efficacy of Antimuscarinic Therapy for Overactive Bladder With Varying Degrees of Incontinence Severity J. RICHARD LANDIS, STEVE KAPLÅN, STEVE SWIFT, and EBOO VERSI J. RICHARD LANDISJ. RICHARD LANDIS , STEVE KAPLÅNSTEVE KAPLÅN , STEVE SWIFTSTEVE SWIFT , and EBOO VERSIEBOO VERSI View All Author Informationhttps://doi.org/10.1097/01.ju.0000103540.71683.e5AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We analyze the efficacy of tolterodine extended release (ER) for overactive bladder in patients with severe incontinence. Materials and Methods: Patients with urinary frequency (8 micturitions or greater per 24 hours), urge incontinence (5 episodes or greater a week) and symptoms of overactive bladder for 6 months or greater were randomized to treatment with 4 mg tolterodine ER once daily or placebo for 12 weeks. Severe incontinence was defined as 21 episodes or greater per week at baseline. Changes in the number of incontinence episodes per week and micturition frequency after 12 weeks were compared between treatments. Results: A total of 986 patients were eligible for this post-hoc analysis. After 12 weeks tolterodine ER produced a significant absolute median reduction in incontinence episodes per week compared to placebo (9.0 vs 5.0, p <0.0001). For patients with severe incontinence at baseline median absolute and percentage reductions in incontinence episodes per week were significantly greater with tolterodine ER than placebo (21.0 vs 9.5, p <0.0001; 67.6% vs 29.8%, p = 0.022). Micturition frequency decreased (p <0.02) and volume voided per micturition (p <0.0001) increased significantly more with tolterodine ER compared with placebo in these patients. For patients with nonsevere incontinence at baseline median reductions in incontinence episodes per week were also significantly greater with tolterodine ER than placebo (6.0 vs 4.0, p <0.0001; 71.4% vs 38.5%, p = 0.026). Conclusions: Patients with more severe incontinence at baseline achieved greater absolute reductions in incontinence with tolterodine compared to those with less severe symptoms. The degree of improvement, as measured by percent change, was comparable across the entire range of baseline incontinence severity strata. Benefits of antimuscarinic therapy may be greater in these patients than previously reported. References 1 : The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn2002; 21: 167. Google Scholar 2 : A review of the quality-of-life aspects of urinary urge incontinence. Pharmacoeconomics1996; 9: 11. 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Google Scholar From the Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania (JRL), College of Physicians and Surgeons, Columbia University, New York, New York (SK), Medical University of South Carolina, Charleston, South Carolina (SS), and Pharmacia Corporation, Peapack, New Jersey (EV)© 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byWein A (2014) Re: Risk Factors for the Failure of Antimuscarinic Treatment with Solifenacin in Women with Overactive BladderJournal of Urology, VOL. 191, NO. 6, (1822-1825), Online publication date: 1-Jun-2014.Green S, Alon A, Ianus J, McNaughton K, Tozzi C and Reiss T (2018) Efficacy and Safety of a Neurokinin-1 Receptor Antagonist in Postmenopausal Women With Overactive Bladder With Urge Urinary IncontinenceJournal of Urology, VOL. 176, NO. 6, (2535-2540), Online publication date: 1-Dec-2006.CHOO M, SONG C, KIM J, CHOI J, LEE J, CHUNG B and LEE K (2018) CHANGES IN OVERACTIVE BLADDER SYMPTOMS AFTER DISCONTINUATION OF SUCCESSFUL 3-MONTH TREATMENT WITH AN ANTIMUSCARINIC AGENT: A PROSPECTIVE TRIALJournal of Urology, VOL. 174, NO. 1, (201-204), Online publication date: 1-Jul-2005. Volume 171Issue 2February 2004Page: 752-756 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsantimuscarinic agentsurinary incontinencebladderMetrics Author Information J. RICHARD LANDIS Financial interest and/or other relationship with Alza Pharmaceuticals, Pharmacia and Bristol-Myers Squibb. More articles by this author STEVE KAPLÅN More articles by this author STEVE SWIFT More articles by this author EBOO VERSI Financial interest and/or other relationship with Pharmacia. More articles by this author Expand All Advertisement PDF downloadLoading ...