Solifenacin in Multiple Sclerosis Patients With Overactive Bladder – A Prospective Study

Abstract

Objective. To assess the efficacy and the effect on Qol of solifenacin for the treatment of OAB in MS patients. Patients and Methods. Thirty MS patients suffering from OAB were treated with solifenacin 5/10 mg for 8 weeks. The first 4 weeks patients received solifenacin 5 mg. At week 4 patients could request a dose increase to 10 mg. The efficacy was evaluated at 8 weeks. Results. After 4 weeks of treatment, 28 patients reported acceptable or no side effects. 17 continued the study with the 10 mg dosage, and 11 stayed on 5 mg solifenacin. Two patients withdrew from the study due to side effects. Solifenacin 5/10 mg for 8 weeks resulted in a significant decrease in number of micturitions and number of pads used per day compared to baseline. Also the severity of urgency prior to voiding decreased significantly, and an increase was seen in the volume per void. Twenty out of 30 patients chose to continue solifenacin therapy after termination of the study. The majority of patients reported global QoL improvement. Conclusions. Solifenacin is effective in the treatment of MS patients with OAB symptoms. This is the first study with solifenacin in a specific neurogenic patient group with a neurogenic disease-specific QoL outcome measure (MS-QoL 54).

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

“…31 Three studies, one with darifencin 32 and two with solifenacin were open-label, noncomparative studies. 33,34 Three studies investigated long-term outcomes of propiverine IR, 35 and fesoterodine, 36 another open-label retrospective study compared tolterodine with oxybutynin. 37 The studies of Tan and Toh, 37 and Yamanishi et al 31 lack important study details.…”

Treatment of lower urinary tract symptoms in multiple sclerosis patients: Review of the literature and current guidelines

“…18 UUI episodes/24 hours decreased from 1.3 to 0.2, number of pads per day dropped from 2.0 to 1.0, frequency/day diminished to 9.5 from 11.7, and micturition volume rose from 121.9 to 155.3 cc.…”

Effects of solifenacin in patients with neurogenic detrusor overactivity as a result of spinal cord lesion

“…In another study evaluating the effects of solifenacin on patients with NDO as a result of multiple sclerosis, no urodynamic data were evaluated. 11 Studies evaluating the urodynamic effects of solifenacin in idiopathic detrusor overactivity, most commonly summarized under 'overactive bladder syndrome' , are rare. This may at least partially be the result of the fact that overactive bladder syndrome in nonneurogenic patients is a clinical diagnosis, not involving urodynamic measurements.…”

“…The percentage of treatment discontinuation as a result of intolerable adverse events reported in the literature is similar to our results for 10 mg solifencain. 11,19,20 Gastrointestinal (dry mouth and constipation) and eye disorders (blurred vision) were the most commonly reported side effects. 20 The abortion rate in our study was very similar to the one reported by van Rey et al 11 in patients suffering from NDO following multiple sclerosis.…”

“…In a study with patients suffering from multiple sclerosis, solifenacin significantly improved voiding frequency, severity of urgency and incontinence. 11 However, no urodynamic data had been reported. We therefore investigated the urodynamic effects of solifenacin treatment for NDO in patients with SCI.…”