Which anticholinergic drug for overactive bladder symptoms in adults

Madhuvrata, Priya; Cody, June D; Ellis, Gaye; Herbison, G Peter; Hay‐Smith, Jean

doi:10.1002/14651858.cd005429.pub2

Cited by 173 publications

(119 citation statements)

References 125 publications

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“…Tolterodina: agente selectivo utilizado para el tratamiento de pacientes con vejiga hiperactiva; los resultados son similares a los de la oxibutinina, pero con mejor tolerancia (39). En niños también se ha documentado la superioridad de la tolterodina sobre la oxibutinina en términos de efectos adversos (40).…”

Section: Tratamiento Farmacológico Anticolinérgicosunclassified

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

Guerrero-Tinoco

Cano-Martínez

Vanegas-Ruiz

2018

iatreia

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RESUMENLa disfunción miccional es un trastorno del llenado o vaciado de la vejiga en niños sin alteraciones neurológicas o anatómicas. Los síntomas del tracto urinario inferior (LUTS, por la sigla en inglés de Lower urinary tract symptoms) son un motivo frecuente de consulta con el pediatra, el nefrólogo o el urólogo pediatra, e incluso con el neurólogo y el psicólogo infantil. Se le considera una enfermedad relativamente benigna lo que en ocasiones genera desinterés entre médicos y familiares y lleva a consultas tardías e interpretación inadecuada de los síntomas. Manifestaciones como urgencia, incontinencia, enuresis, goteo posmiccional, infecciones urinarias, vulvovaginitis recurrente y constipación, en un niño sin enfermedad neurológica, deben hacer pensar al médico en disfunción miccional para enfocar oportunamente el diagnóstico, restablecer la calidad de vida del paciente, evitar las infecciones urinarias y el daño renal subsecuente e irreversible secundario a un diagnóstico tardío. Las recomendaciones actuales hacen énfasis en un enfoque menos invasivo, tratamiento conservador, manejo de la constipación y reentrenamiento vesical. Este artículo discute la evaluación, el diagnóstico y el tratamiento correctos de niños con LUTS.

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Section: Tratamiento Farmacológico Anticolinérgicosunclassified

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

Guerrero-Tinoco

Cano-Martínez

Vanegas-Ruiz

2018

iatreia

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“…Efficacy and safety of antimuscarinics are well described for the non-neurogenic overactive bladder population [24,25] 28]. Differences in the safety and tolerability profiles seem to be more relevant and should be considered when choosing an antimuscarinic drug for a specific patient, especially considering central nervous side-effects [28,29].…”

Section: Drugsmentioning

confidence: 99%

The management of urinary incontinence in the male neurological patient

Mehnert

Kessler

2014

Current Opinion in Urology

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PURPOSE OF REVIEW: Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. RECENT FINDINGS: Intermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SUMMARY: Standard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in male neurological patients, well-designed, multicenter studies are warranted. Purpose of review Urinary incontinence in male neurological patients is a very frequent problem but treatment remains challenging. Thus, we summarize and highlight the latest developments in the management of urinary incontinence in this specific patient population. Recent findingsIntermittent self-catheterization, antimuscarinics, intradetrusor injections with onabotulinumtoxinA, augmentation cystoplasty, urinary diversion, and artificial urinary sphincter are the cornerstones of the armamentarium for treating neurogenic urinary incontinence. However, with the exception of onabotulinumtoxinA intradetrusor injections, level of evidence is often low and male-specific outcomes are virtually not available. Alternative conservative and/or minimally invasive procedures such as neuromodulation techniques and suburethral suspension devices provide promising data with apparently good safety and tolerability but still insufficient evidence lacking randomized control trials. SummaryStandard options for treatment of urinary incontinence in neurological patients remain largely unchanged. Alternative treatment options, especially of conservative or minimally invasive character, have the potential to further broaden the therapeutic spectrum. While a higher level of evidence is needed to assess the potential of such therapeutic approaches, randomized controlled trials in the male neurological population present a challenge. To truly advance treatment of urinary continence in mal...

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“…The efficacy of solifenacin 5 and 10 mg (fixed doses) and 5 mg/10 mg (flexible dosing schedule) has been comprehensively studied in a series of large randomized controlled trials (RCTs) in patients with OAB [9–12]. These show that solifenacin is significantly more effective than placebo [9,10], and provides greater efficacy than tolterodine for most outcomes [9,11,12]. The most commonly reported adverse events (AEs) with solifenacin are dry mouth and constipation [9,10].…”

Section: Introductionmentioning

confidence: 99%

Cost-effectiveness of solifenacin compared with oral antimuscarinic agents for the treatment of patients with overactive bladder in the UK

Hakimi

Kelleher

Aballéa

et al. 2018

Journal of Market Access & Health Policy

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Objective: To evaluate the cost-effectiveness of solifenacin 5 mg/day versus other oral antimuscarinic agents used for overactive bladder (OAB) from a UK National Health Service (NHS) perspective. Study design: In a Markov model, hypothetical patients received solifenacin 5 mg/day or a comparator antimuscarinic, after which they could switch to an alternative antimuscarinic. The model estimated incremental cost-effectiveness ratios (ICER), expressed as cost per quality-adjusted life year (QALY) over a 5-year period. Results: Solifenacin 5 mg/day was the dominant treatment strategy (i.e., less costly and more effective) versus tolterodine extended-release (ER) 4 mg/day, fesoterodine 4 and 8 mg/day, oxybutynin ER 10 mg/day and solifenacin 10 mg/day, and was cost-effective (i.e., ICERs below the £30,000 per QALY threshold generally applied in the NHS) versus oxybutynin immediate release (IR) 10 mg/day, tolterodine IR 4 mg/day and trospium chloride 60 mg/day. The probability of solifenacin 5 mg/day being dominant/cost-effective at a willingness-to-pay threshold of £30,000 per QALY was 57–98%. Conclusions: Solifenacin 5 mg/day appears to be a cost-effective strategy for the treatment of OAB over a 5-year timeframe compared with other oral antimuscarinic agents in the UK. These findings are important for decision-makers considering the economic implications of selecting treatments for OAB.

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Which anticholinergic drug for overactive bladder symptoms in adults

Cited by 173 publications

References 125 publications

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

Evaluación y tratamiento del niño con síntomas del tracto urinario inferior (LUTS)

The management of urinary incontinence in the male neurological patient

Cost-effectiveness of solifenacin compared with oral antimuscarinic agents for the treatment of patients with overactive bladder in the UK

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