Investigation of the clinical efficacy and safety of pregabalin alone or combined with tolterodine in female subjects with idiopathic overactive bladder

Marencak, Josef; Cossons, Nandini; Darekar, Amanda; Mills, Ian W.

doi:10.1002/nau.20928

Cited by 32 publications

(17 citation statements)

References 24 publications

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“…Research published in 2005 has shown that gabapentin and carbamazepine reduce the intensity of temporal summation-induced pain, consistent with an ameliorating effect of these agents on central sensitization 157 . Interestingly, gapapentin 158 and pregabalin 159 have both been investigated as treatments of OAB in studies with small cohort sizes, but with encouraging results. Treatment with duloxetine, compared with placebo, also improves the outcomes of patients with OAB 160 , but these results have not been confirmed in other clinical trials.…”

Section: Implications For Oab Treatmentmentioning

confidence: 99%

Does central sensitization help explain idiopathic overactive bladder?

et al. 2016

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The pathophysiological mechanisms underlying overactive bladder syndrome (OAB) can include dysfunction of sensory pathways of the peripheral and central nervous systems, resulting in bladder hypersensitivity. Central sensitization describes an induced state of spinal hypersensitivity that is associated with a variety of chronic pain disorders that share many attributes with OAB, albeit without the presence of pain. As such, the concept of central sensitization might be relevant to understanding the mechanisms and clinical manifestations of OAB syndrome. An understanding of the pathophysiology and clinical manifestations of central sensitization, and the evidence that supports a role of central sensitization in OAB, including the potential implications of mechanisms of central sensitization for the treatment of patients with OAB could provide a novel approach to the treatment of patients with this disease. Such an approach would be especially relevant to those patients with central sensitization-related comorbidities, and has the potential to improve the outcomes of these patients in particular.

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Section: Implications For Oab Treatmentmentioning

confidence: 99%

Does central sensitization help explain idiopathic overactive bladder?

et al. 2016

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“…We find it interesting that despite many combination therapy studies being less than robust in terms of design or number of patients studied, there is a significant body of research assessing the utility of off‐label treatments in combination with approved OAB therapies. Several of these studies focus on nonapproved neuromodulation techniques that have yet to undergo proper clinical trials (even as monotherapies) while in other studies, the use of off‐label medications such as desmopressin, pregabalin, vaginal estrogen, and Weng‐li‐Tong (an herbal medicine) were investigated . Interestingly, several of these combinations were able to elicit a clinical benefit with improvements in OAB symptoms compared to monotherapy, however, as these treatments are not standard of care, it is not clear if they will garner widespread use.…”

Section: Discussionmentioning

confidence: 99%

Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature

Kasman

Stave

Elliott

2019

Neurourology and Urodynamics

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Aims Overactive bladder (OAB) affects over 17% of the population and significantly effect the health‐related quality of life. The treatments for OAB include first line (lifestyle modification, pelvic floor muscle training), second line (anticholinergic or beta‐3 agonist medications), and third line therapies (intradetrusor botulinum toxin injection, sacral neurostimulation [SNM], or percutaneous tibial nerve stimulation [PTNS]). For those with urinary incontinence secondary to OAB, complete continence is the goal of therapy, though cure rates are only 5% to 40%. The use of combination therapies can be employed in refractory OAB, however, the efficacy of pooled modalities is relatively unknown. Our objective was to determine the volume of data supporting combination therapy in treating OAB. Methods We systematically reviewed PubMed, EMBASE, the Cochrane Library, and Google Scholar for articles published before October 2018. Each was independently reviewed by two reviewers and examined in detail if they met inclusion criteria. Results A total of 32 studies met inclusion criteria and were reviewed. Most large prospective studies evaluated combinations of medications with behavioral therapy or medications together. Combination therapy studies of third‐line treatments were rare and centered on medication with PTNS. No studies examined intradetrusor botulinum toxin injections in combination with another therapy and only one retrospective study briefly examined SNM therapy in combination with medication. Conclusion Combination therapy, with certain first, second, and third‐line OAB therapies, appears to be efficacious. There is a further need for carefully designed combination therapy studies, particularly those including third line modalities.

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“…Patients taking benzodiazepines and baclofen may have lower urethral resistance due to external and periurethral sphincter relaxation. Pregabalin has been described as a potential detrusor muscle relaxing drug in rats and increases mean voided volume in overactive bladder women . Only serotonin‐norepinephrine reuptake inhibitors may play a role increasing urethral resistance through a theoretically increase of the tone of external and periurethral sphincter, but in clinical practice this fact is very rarely observed.…”

Section: Discussionmentioning

confidence: 99%

Urodynamic findings in amyotrophic lateral sclerosis patients with lower urinary tract symptoms: Results from a pilot study

Arlandis

Vázquez-Costa

Martínez-Cuenca

et al. 2016

Neurourology and Urodynamics

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In this small pilot study we found a high prevalence of csLUTS in ALS which are mainly related to a combination of voiding and storage symptoms. In most patients, symptoms are caused by overactive detrusor combined with non-relaxing sphincter. Severity of symptoms and impact in QoL is only moderate but in a subset of patients can be considerable. Neurourol. Urodynam. 36:626-631, 2017. © 2016 Wiley Periodicals, Inc.

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Investigation of the clinical efficacy and safety of pregabalin alone or combined with tolterodine in female subjects with idiopathic overactive bladder

Abstract: Pregabalin, alone or with tolterodine ER may offer an alternative treatment option for idiopathic OAB in women.

Cited by 32 publications

References 24 publications

Does central sensitization help explain idiopathic overactive bladder?

Does central sensitization help explain idiopathic overactive bladder?

Combination therapy in overactive bladder‐untapped research opportunities: A systematic review of the literature

Urodynamic findings in amyotrophic lateral sclerosis patients with lower urinary tract symptoms: Results from a pilot study

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