A new once-daily formulation of tolterodine provides superior efficacy and is well tolerated in women with overactive bladder

Abstract

This study evaluated the efficacy and tolerability of new extended-release (ER) tolterodine for the treatment of overactive bladder in women. In this subpopulation analysis of a double-blind multicenter trial, 1235 female patients were randomized to oral therapy with tolterodine ER 4 mg once daily (n=417), tolterodine IR 2 mg twice daily (n=408) or placebo (n=410) for 12 weeks. Both formulations reduced the mean number of urge incontinence episodes per week (both P=0.001 vs placebo); tolterodine ER was more effective than tolterodine IR (P=0.036). Both formulations significantly improved all other micturition chart variables compared to placebo. Dry mouth was the most common adverse event. There were no safety concerns. Toltrodine ER 4 mg once daily is effective and well tolerated in the treatment of women with overactive bladder, and reduces urge incontinence episodes more than the existing IR twice-daily formulation.

Update on drugs for overactive bladder syndrome

“…The rate of dry mouth was 23% with modified-release tolterodine (vs. 30% with immediate-release tolterodine, p<0.02, and 8% with placebo). In the second study, involving 1,235 women, both tolterodine preparations also reduced the mean number of incontinence episodes per week more than placebo (11.8 fewer with modified-release [p = 0.001] and 10.1 fewer with immediate-release [p = 0.001] vs. 7.2 fewer with placebo) 31. Dry mouth was the most common unwanted effect (25.3% with modified-release and 31.2% with immediate-release vs. 8.0% with placebo, p<0.01).…”

“…Two published double-blind randomised placebo-controlled trials lasting 12 weeks have assessed modified-release tolterodine 4mg daily and immediate-release tolterodine 2mg twice daily in patients with overactive bladder including urinary frequency (8 or more micturitions per 24 hours) and urge incontinence (5 or more episodes per week) 30 , 31. The primary outcome measure was the change from baseline in the number of incontinence episodes per week.…”

Anticholinergiques et hyperactivité vésicale

“…Il est métabolisé dans le foie par CYP2D6 en 5-hydroxyméthyl, un métabolite actif. Il est commercialisé sous forme de médicaments à libération immédiate (administrés 2 fois par jour) (Detrol, Détrusol) et de médicaments à libération prolongée (administrés 1 fois par jour) (Detrol LA : 2 mg et 4 mg, Détrusol XL), ces derniers offrant une efficacité et une tolérabilité supérieures en raison de l'atténuation de la sécheresse buccale 41 . Il a pour effets secondaires la sécheresse buccale, la constipation et la vision embrouillée, et est contre-indiqué en cas de glaucome à angle fermé 39 .…”

Complications of sacral anterior root stimulator implantation in a cervical spinal cord injury patient: increased spasms requiring intrathecal baclofen therapy followed by delayed fracture of lumbar spine leading to intractable spasms compelling disuse of the sacral anterior root stimulator

“…With the advent of modified-release formulations of antimuscarinic drugs 6,7 and patch formulation of oxybutynin for transdermal use, 8 it is claimed that these preparations are as effective as the conventional oral drug, with less dry mouth. Further, new types of catheters for intermittent catheterisation, for example, LoFric H 2 O and LoFric Hydro-Kit (Astra Tech, UK) are now available, and these catheterisation kits are patient-friendly.…”