Listening to the patient: a flexible approach to the use of antimuscarinic agents in overactive bladder syndrome

Chapple, Christopher R.; Rosenberg, Matt T.; Brenes, Francisco

doi:10.1111/j.1464-410x.2009.08545.x

Cited by 39 publications

(32 citation statements)

References 29 publications

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“…Once-daily formulations have been developed for several anticholinergic agents in order to improve patient compliance and tolerability [16]; however the negative side of such formulations is that they only allow for fixed dosing. Nowadays, results of randomized, controlled clinical trials as well as open label, flexible-dose studies indicate the advantages of adaptable dosing, which allow a more personalized treatment [13][14][15]17]. This approach considers the individual sensitivity of the patient to the drug as well as the willingness to tolerate a certain degree of side effects.…”

Section: Discussionmentioning

confidence: 99%

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Flexible Dosing of Trospium Chloride for the Treatment of OAB – Results of a Non-Interventional Study in 4,092 Patients

Wiedemann¹

2011

TOCTJ

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Introduction & Objectives:This was a multicenter, non-interventional study performed in urology practices investigating prescribed dosage regimens as well as the efficacy and tolerability of an oral therapy with trospium chloride in patients with overactive bladder (OAB) under routine conditions. Material and Methods: Naive or insufficiently treated OAB patients in which oral therapy with trospium chloride 1 was prescribed by the physician were eligible to participate. Dosing and duration of treatment were not predetermined. Core symptoms of OAB, a Quality of Life (QoL) score as well as dosage regimens were assessed at the beginning and at two consecutive visits. Adverse events and withdrawals were documented.Results: In 4,092 cases pre and post treatment data was available for the evaluation of efficacy; all 4,167 cases were included in the safety analysis. After a mean treatment period of 40 days, all core symptoms of OAB had improved e.g. the median total of micturitions was reduced from 12 to 8 (day) and from 3 to 1 (night). The percentage of incontinent patients dropped from 54.4% to 29.1%. The proportion of patients requiring incontinence pads was reduced from 47.6% to 30.1%. The median QoL score had improved from 3 to 1. Only 20% of the patients were treated with the standard dose of 45mg trospium chloride. Nearly 50% of the patients received 30mg (or less), and 60mg to 90mg were prescribed in 30% of the cases. There were 300 early treatment withdrawals (7.3%) and 54 patients experienced adverse events (1.3%). Conclusions:The distinct majority of OAB patients benefit from flexible dosing of trospium chloride, a compound with an equally favorable efficacy and tolerability profile.

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Section: Discussionmentioning

confidence: 99%

“…Fixed dosing does not seem to be suitable for all patients. Currently, flexible dosing of antimuscarinic agents has become the strategy of choice to meet the needs of the individual patient [13].…”

Section: Introductionmentioning

confidence: 99%

Flexible Dosing of Trospium Chloride for the Treatment of OAB – Results of a Non-Interventional Study in 4,092 Patients

Wiedemann¹

2011

TOCTJ

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“…Algunos estudios consideran esta variabilidad individual dosis-respuesta y aconsejan que el paciente pueda participar aumentando o disminuyendo la dosis de antimuscarinico, en base a la presencia de beneficios terapéuticos, gravedad de los sín-tomas y efectos secundarios, permitiendo a los pacientes tener más control sobre la VH dentro de un régimen de dosificación flexible 59,60 .…”

Section: Fármacos Antimuscarínicosunclassified

Documento de consenso sobre vejiga hiperactiva en el paciente mayor

Verdejo-Bravo¹,

Brenes-Bermúdez

Valverde-Moyar³

et al. 2015

Revista Española de Geriatría y Gerontología

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“…8,9 Switching from one antimuscarinic to another may also be effective for some patients. Market research has shown that the majority of patients who have discontinued one antimuscarinic therapy are willing to try another agent.…”

Section: Adjusting Antimuscarinic Therapymentioning

confidence: 99%