Efficacy and Safety of Propiverine in Children with Overactive Bladder

Abstract

PurposeAntimuscarinic therapy remains one of the most common forms of therapy for overactive bladder (OAB) in children. However, few clinical studies on the outcomes of antimuscarinics in children with OAB have been published. Therefore, we evaluated the efficacy and safety of propiverine, which is frequently prescribed for the treatment of pediatric OAB.Materials and MethodsWe retrospectively reviewed children with OAB treated with propiverine within the past 5 years. The response rates were compared between the non-urge incontinence (non-UI) and urge incontinence (UI groups). The cumulative response rate by treatment duration was also compared between the two groups.ResultsAmong a total of 68 children, 50 children (73.5%) experienced UI. The overall response rate was 86.8%. Functional bladder capacity after treatment was 150 ml, which represented an increase compared with the value (140 ml) before treatment. The voiding frequency per day decreased from 14.0 to 8.5 times. The overall response rate (88.0%) in the non-UI group was not significantly different from that seen in the UI group (83.3%; p>0.05). In non-UI children, the cumulative response rates were 36.0%, 54.0%, 68.0%, 74.0%, 76.0%, and 78.0% at 4, 8, 12, 16, 20, and 24 weeks, respectively. The cumulative response rates in the UI children were 11.1%, 33.3%, 44.4%, 50.0%, 50.0%, and 55.6%, respectively during the same respective time periods. Adverse effects were identified in only two (2.9%) patients, and neither case was severe.ConclusionsPropiverine is effective and well tolerated as a treatment for children suffering from OAB with or without UI.

Efficacy and Tolerability of Anticholinergics in Korean Children with Overactive Bladder: A Multicenter Retrospective Study

“…Moreover, oxybutynin extended release (ER) rather than oxybutynin immediate release (IR) is widely administered because of fewer adverse effects. Oxybutynin ER is only available in tablet form, which is difficult for infants and toddlers to swallow ( 15 ). Although several anticholinergics should be clinically used in the management of OAB for pediatric patients refractory to oxybutynin, use of antimuscarinic medications for treatment of OAB has not been studied as extensively in children as it has in adults.…”

Long-term use of solifenacin in pediatric patients with overactive bladder: Extension of a prospective open-label study

“…20 Aside from oxybutynin, which is FDA-approved for children, reports on use in children with OAB are provided for tolterodine, trospium and propiverine. [5][6][7][8][9][10][11][12] Hoebeke and colleagues performed a retrospective uncontrolled study in 138 children with therapy resistant non-neurogenic overactive bladder whom they treated with solifenacin for a mean of 23 months. They found solifenacin effective with an overall 85% response rate, a full response in more than 50% and side effects in only 6.5% of their cohort.…”

“…4 Data about the safety and efficacy of newer agents in children are scarce. Although there have been reports about the use of tolterodine, 5-9 trospium 10 and propiverine 11,12 in children, to date only oxybutynin chloride has been officially approved for pediatric use by medical authorities in North America. Solifenacin is a tertiary amine approved by the FDA for OAB in adults since 2005.…”

Overactive bladder in children

“…40 Kim et al reported an overall response rate of 86.8% in a retrospective review of 68 children. 41 A multicentre, observational, cohort study comparing propiverin to oxybutynin demonstrated that propiverine was at least as effective as oxybutynin and that it had a favourable tolerability profile over oxybutynin. 42 …”