Propiverine Compared to Oxybutynin in Neurogenic Detrusor Overactivity – Results of a Randomized, Double-blind, Multicenter Clinical Study

Stöhrer, M.; Mürtz, Gerd; Kramer, Guus; Schnabel, Frieder; Arnold, E. P.; Wyndaele, J J

doi:10.1016/j.eururo.2006.03.016

Cited by 97 publications

(77 citation statements)

References 16 publications

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“…4 In contrast to IDO/OAB, AM drugs decrease the maximum detrusor pressure in NDO 38 up to B40 cm H 2 O, as was shown in SCI patients. [13][14][15][19][20][21] According to Mc Guire's et al 39 findings, this is the crucial detrusor leak point pressure in children with NLUTD due to myelomeningocele. However, there is no evidence for this threshold value in adults.…”

Section: Discussionmentioning

confidence: 99%

“…13,14,16,17 The most frequently reported AE was dry mouth, higher incidence rates are reported for oxybutynin IR compared with trospium chloride IR, 19 tolterodine 16 and propiverine. 20 Higher doses of AM were not necessarily associated with higher rates of AE. 22,24,27 The combination of two different AM, administered in higher-than-recommended dosages, revealed increased rates of AE, resulting in a drop-out rate of 15% because of typical AM AE.…”

Section: Antimuscarinics-ndo H Madersbacher Et Almentioning

confidence: 99%

“…[13][14][15] Unequivocally, placeboand active-controlled studies with reported urodynamic outcomes demonstrated a significant decrease of B30-40% in maximum detrusor pressure, paralleled by a significant increase of maximum cystometric bladder capacity of B30-40% for oxybutynin IR, propiverine IR, propiverine ER and trospium chloride IR. [13][14][15][19][20][21] The effects of solifenacin 10 mg were distinctly less pronounced. 17 Moreover, equieffectivity of oxybuynin IR 5 mg t. 21 Results on changes of bladder compliance and in duration of detrusor contraction 14 were incompletely or not at all reported.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…AM were administered at 10,14,20,21 PT (1) 19 Due to "double counting" (e.g. for active-controlled studies or studies administering two antimuscarinics concomitantly) the counts within the boxes, adding up all antimuscarinic treatment arms, can be deviant to the number of studies given in the respective headings.…”

Section: Search Strategymentioning

confidence: 99%

“…Six active-controlled studies (Table 1c) compared oxybutynin IR with propantheline IR, 18 oxybutynin IR with trospium chloride IR, 19 oxybutynin IR with propiverine IR, 20 oxybutynin IR with tolterodine IR, 16 propiverine IR with propiverine ER 21 and solifenacin with oxybutynin. 17 Flexible dose studies and combined high-dose AM.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Neurogenic detrusor overactivity in adults: a review on efficacy, tolerability and safety of oral antimuscarinics

Madersbacher

Mürtz²,

Stöhrer

2013

Spinal Cord

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Objectives: This review analyzed efficacy, tolerability and safety of oral antimuscarinic (AM) drugs in adults suffering from neurogenic detrusor overactivity (NDO). Methods: A comprehensive search of major literature bases was conducted to identify all references. Results: Thirty studies, thereof 16 randomized controlled trials (RCT), enrolling 1479 patients were identified and included in the review. Results were grouped in dose-finding, placebo-and active-controlled, flexible dose and combined high-dose AM drugs, and various studies. Key urodynamic outcome parameters, such as maximum detrusor pressure and maximum cystometric bladder capacity, demonstrated the efficacy of AM in NDO, following 2-3 weeks of treatment. Contrary to idiopathic detrusor overactivity (IDO), no placebo effects manifested. Other important parameters, such as impact on the upper urinary tract function and morphology, issues of continence, post-void residual urine, catheterisation, urinary tract infections and quality of life, were investigated to a limited extent only. Incidence rates of adverse events were comparable for NDO and IDO. Most of the studies, especially RCT, were undertaken with oxybutynin immediate release (IR), trospium chloride IR, propiverine IR and propiverine extended release. In NDO, these drugs are best investigated. Conclusions: AM drugs are effective in NDO, they normalize the intravesical pressure and increase cystometric bladder capacity. However, other important parameters are not adequately investigated so far and should be recognized in future studies.

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