Anticholinergic drugs versus placebo for overactive bladder syndrome in adults

Abstract

The use of anticholinergic drugs by people with overactive bladder syndrome results in statistically significant improvement in symptoms. However, the clinical significance of these differences is uncertain, and the longer-term effects are not known. Dry mouth is a common side effect of therapy.

Epidemiology, prescribing patterns and resource use associated with overactive bladder in UK primary care

“…This study also suggests that 28% of patients presenting with symptoms of OAB receive anticholinergic medication. This is lower than might be expected based on national and international guidance recommending first‐line use of these agents (9–13) and systematic reviews demonstrating their efficacy (8) but is similar to the figure observed in a recent survey (2). Additionally, there was, on average, a delay of 1.11 years between the onset of symptoms and patients’ first prescription for OAB medication.…”

Epidemiology, prescribing patterns and resource use associated with overactive bladder in UK primary care

“…This study also suggests that 28% of patients presenting with symptoms of OAB receive anticholinergic medication. This is lower than might be expected based on national and international guidance recommending first‐line use of these agents (9–13) and systematic reviews demonstrating their efficacy (8) but is similar to the figure observed in a recent survey (2). Additionally, there was, on average, a delay of 1.11 years between the onset of symptoms and patients’ first prescription for OAB medication.…”

The role of anticholinergics in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a systematic review and meta‐analysis

“…However, there might be sources of bias common to these studies. The significant placebo effect seen in symptoms of OAB is well‐reported [10]. The relatively few trials using a placebo comparison means the effect is less apparent in this review, although the absence of combined preparations or placebo amongst the control arms of trials using an α‐blocker comparison might result in an overestimate of the intervention efficacy.…”

Quality Indicators for the Screening and Care of Urinary Incontinence in Vulnerable Elders

“…The evidence supporting lifestyle, behavioral, and surgical treatments is discussed elsewhere in this article (QIs #12–14). Several systematic reviews evaluated the evidence for using medications to treat UI 32,34,35 . As is the case for many of the articles found on lifestyle, behavioral, and surgical treatments, these reviews did not focus on VEs.…”

“…Three RCTs reported improvement in bladder stability 34 . A systematic review 35 of 51 trials on antimuscarinic medications for treatment of overactive bladder syndrome found that antimuscarinic medications are associated with statistically significant improvement in symptoms (subjective cure or improvement relative risk (RR)=1.41, 95% confidence interval (CI)=1.29–1.54; change in leakage episodes in 24 hours weighted mean difference=−0.56, 95% CI=−0.73–0.39). In sensitivity analyses, age did not appear to modify these effects, although the small number of trials limited analyses.…”

Epidemiology, prescribing patterns and resource use associated with overactive bladder in UK primary care

“…This study also suggests that 28% of patients presenting with symptoms of OAB receive anticholinergic medication. This is lower than might be expected based on national and international guidance recommending first‐line use of these agents (9–13) and systematic reviews demonstrating their efficacy (8) but is similar to the figure observed in a recent survey (2). Additionally, there was, on average, a delay of 1.11 years between the onset of symptoms and patients’ first prescription for OAB medication.…”

The role of anticholinergics in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a systematic review and meta‐analysis

“…However, there might be sources of bias common to these studies. The significant placebo effect seen in symptoms of OAB is well‐reported [10]. The relatively few trials using a placebo comparison means the effect is less apparent in this review, although the absence of combined preparations or placebo amongst the control arms of trials using an α‐blocker comparison might result in an overestimate of the intervention efficacy.…”

Quality Indicators for the Screening and Care of Urinary Incontinence in Vulnerable Elders

“…The evidence supporting lifestyle, behavioral, and surgical treatments is discussed elsewhere in this article (QIs #12–14). Several systematic reviews evaluated the evidence for using medications to treat UI 32,34,35 . As is the case for many of the articles found on lifestyle, behavioral, and surgical treatments, these reviews did not focus on VEs.…”

“…Three RCTs reported improvement in bladder stability 34 . A systematic review 35 of 51 trials on antimuscarinic medications for treatment of overactive bladder syndrome found that antimuscarinic medications are associated with statistically significant improvement in symptoms (subjective cure or improvement relative risk (RR)=1.41, 95% confidence interval (CI)=1.29–1.54; change in leakage episodes in 24 hours weighted mean difference=−0.56, 95% CI=−0.73–0.39). In sensitivity analyses, age did not appear to modify these effects, although the small number of trials limited analyses.…”

Epidemiology, prescribing patterns and resource use associated with overactive bladder in UK primary care

“…This study also suggests that 28% of patients presenting with symptoms of OAB receive anticholinergic medication. This is lower than might be expected based on national and international guidance recommending first‐line use of these agents (9–13) and systematic reviews demonstrating their efficacy (8) but is similar to the figure observed in a recent survey (2). Additionally, there was, on average, a delay of 1.11 years between the onset of symptoms and patients’ first prescription for OAB medication.…”

The role of anticholinergics in men with lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a systematic review and meta‐analysis

“…However, there might be sources of bias common to these studies. The significant placebo effect seen in symptoms of OAB is well‐reported [10]. The relatively few trials using a placebo comparison means the effect is less apparent in this review, although the absence of combined preparations or placebo amongst the control arms of trials using an α‐blocker comparison might result in an overestimate of the intervention efficacy.…”

Quality Indicators for the Screening and Care of Urinary Incontinence in Vulnerable Elders

“…The evidence supporting lifestyle, behavioral, and surgical treatments is discussed elsewhere in this article (QIs #12–14). Several systematic reviews evaluated the evidence for using medications to treat UI 32,34,35 . As is the case for many of the articles found on lifestyle, behavioral, and surgical treatments, these reviews did not focus on VEs.…”

“…Three RCTs reported improvement in bladder stability 34 . A systematic review 35 of 51 trials on antimuscarinic medications for treatment of overactive bladder syndrome found that antimuscarinic medications are associated with statistically significant improvement in symptoms (subjective cure or improvement relative risk (RR)=1.41, 95% confidence interval (CI)=1.29–1.54; change in leakage episodes in 24 hours weighted mean difference=−0.56, 95% CI=−0.73–0.39). In sensitivity analyses, age did not appear to modify these effects, although the small number of trials limited analyses.…”