Efficacy and Safety of Propiverine Hydrochloride for Overactive Bladder in Adult: a Systematic Review and Meta-analysis

Abstract

We carried out a systematic review and metaanalysis to assess the efficacy and safety of propiverine for treating overactive bladder (OAB) in adult. A literature review was performed to identify all published randomized placebocontrolled trials (RCT) of propiverine for the treatment of OAB. The search included the following databases: PUBMED and EMBASE. The reference lists of retrieved studies were also investigated. A systematic review and meta-analysis were conducted. Ten publications involving nine different RCTs were used in the analysis. We found that propiverine was effective in treating OAB in our meta-analysis. The decrease in number of micturitions/24 h (P<0.00001, the mean decrease was from 1.80 to 2.57) indicated that propiverine was more effective than the placebo. Propiverine also decrease the number of urgency, urgency incontinence, and nocturia and increase urine volume. However, the incidence of difficulty in voiding was higher with propiverine therapy compared with the placebo (P=0.05, the mean percentage range from 0.34 to 4.93 %). The decrease of total international prostate symptom score (IPSS) (P<0.0001, the mean decrease was from 12.5 to 16.1) indicated that propiverine add a1-adrenoceptor antagonist was more effective in decreasing the lower urinary tract symptom (LUTS). The combination therapy also decreases the voiding symptom and storage symptom scores and increases maximum flow rate. This meta-analysis shows that propiverine is a safe and effective treatment for OAB. The major adverse event associated with propiverine treatment was difficulty in voiding. Propiverine add a1-adrenoceptor antagonist was more effective in terms of decreasing difficulty in voiding.

Efficacy and safety of propiverine in patients with overactive bladder and neurogenic detrusor overactivity

“…According to the results of five studies involving 2891 participants (1648 in the treatment group and 1243 in the control group) on the effects of propiverine hydrochloride on the overactive bladder, the increase in urine volume per voiding (ml) was significantly higher in the propiverine group compared to the control group (P< 0.00001) (Figure 1). 11 In dose determination studies, it has been reported that 50% improvement was observed in the efficacy parameters in the group given 15 mg/day, while the efficacy reached 80% in the group given 30 mg/day. 21 The subjective improvement in OAB patients with the use of propiverine has been shown to be 77%.…”

Literature Review: Efektivitas, Keamanan, dan Biaya Terapi Imidafenacin untuk Pasien Overactive Bladder

“…Perbandingan Efektivitas Imidafenacin dengan Golongan Antimuskarinik Lain (Huang, et al, 2015;Wu, et al, 2020) Tabel 3. Perbandingan Keamanan Imidafenacin dengan Golongan Antimuskarinik Lain (Huang et al, 2015;Wu et al, 2020) Pengarang Hasil kajian sistematik dan meta-analisis terkait perbedaan efektivitas imida-fenacin dengan golongan antimuskarinik lain pada tabel 2, dan kajian terkait keamanan pada tabel 3 terlihat mayoritas penelitian menunjukkan efektivitas imidafenacin yang setara dibandingkan dengan antimuskarinik yang lain. Dengan kata lain, penggunaan imidafenacin tidak menghasilkan efek positif terhadap pasien yang lebih superior dibandingkan dengan pembanding termasuk tolterodine, fesoterodine, propiverine, dan solifenacin.…”

“…Dengan kata lain, penggunaan imidafenacin tidak menghasilkan efek positif terhadap pasien yang lebih superior dibandingkan dengan pembanding termasuk tolterodine, fesoterodine, propiverine, dan solifenacin. Ditinjau dari sisi keamanan penggunaan, imidafenacin lebih jarang menyebabkan ROTD berupa mulut kering (relative risk [RR] 0,87; 95% confidence interval [CI] 0,75-1,00) dan konstipasi (RR 0,68; 95% CI 0,50-0,93) bila dibandingkan dengan golongan anti-muskarinik lainnya (Huang, et al, 2015;Nazir, et al, 2018;Wu, et al, 2020). Namun demikian, kejadian jenis ROTD yang lain relatif tidak berbeda secara signifikan antara kelompok yang mendapat imidafenacin dan antimiskarinik lain yang ada di Indonesia.…”

Pharmacotherapy in overactive bladder

“…Propiverine has both an antimuscarinic action and also acts as an inhibitor of cellular calcium influx, thereby reducing muscle spasm. 25 It has been shown to suppress adenosine triphosphate (ATP)-induced overactivity in rats, and may therefore also have an effect on sensory pathways. 26 It has been shown to be more effective than placebo in a meta-analysis, although sample sizes were not large and unpublished data were not included in the analysis, which could have resulted in bias.…”

“…26 It has been shown to be more effective than placebo in a meta-analysis, although sample sizes were not large and unpublished data were not included in the analysis, which could have resulted in bias. 25 It is available in both IR and ER formulations, at a dose of 15 mg one to three times daily as IR and 30 mg once daily as ER. 13…”