Propiverine vs oxybutynin for treating neurogenic detrusor overactivity in children and adolescents: results of a multicentre observational cohort study

Madersbacher, H.; Mürtz, Gerd; Alloussi, S.; Domurath, Burghard; Henne, Thomas; Körner, I.; Niedeggen, Andreas; Nounla, J.; Pannek, Jürgen; Schulte-Baukloh, Heinrich; Schultz-Lampel, D.; Bock, Paul R.; Strugala, Gerhard

doi:10.1111/j.1464-410x.2008.08093.x

Cited by 25 publications

(18 citation statements)

References 24 publications

(58 reference statements)

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“…Madersbacher et al [66] enrolled 255 children and adolescents with NDO at 14 study centers. In all, 127 patients given propiverine and 128 given oxybutynin were enrolled.…”

Section: Propiverinementioning

confidence: 99%

An Overview on Mixed Action Drugs for the Treatment of Overactive Bladder and Detrusor Overactivity

Asimakopoulos

Cerruto²,

Popolo³

et al. 2012

Urol Int

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Objectives: To provide an overview on the efficacy, tolerability, safety and health-related quality of life (HRQoL) of drugs with a mixed action used in the treatment of overactive bladder (OAB). Evidence Acquisition: MEDLINE database and abstract books of the major conferences were searched for relevant publications from 1966 to 2011 and using the key words ‘overactive bladder’, ‘detrusor overactivity’, ‘oxybutynin’, ‘propiverine’, and ‘flavoxate’. Two independent reviewers considered publications for inclusion and extracted relevant data, without performing a meta-analysis. Evidence Synthesis: Old and conflicting data do not support the use of flavoxate, while both propiverine and oxybutynin were found to be more effective than placebo in the treatment of OAB. Propiverine was at least as effective as oxybutynin but with a better tolerability profile even in the pediatric setting. Overall, no serious adverse event for any product was statistically significant compared to placebo. Improvements were seen in HRQoL with treatment by the oxybutynin transdermal delivery system and propiverine extended release. Conclusions: While there is no evidence to suggest the use of flavoxate in the treatment of OAB, both oxybutynin and propiverine appear efficacious and safe. Propiverine shows a better tolerability profile than oxybutynin. Both drugs improve HRQoL of patients affected by OAB. Profiles of each drug and dosage differ and should be considered in making treatment choices.

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“…Madersbacher et al [66] enrolled 255 children and adolescents with NDO at 14 study centers. In all, 127 patients given propiverine and 128 given oxybutynin were enrolled.…”

Section: Propiverinementioning

confidence: 99%

An Overview on Mixed Action Drugs for the Treatment of Overactive Bladder and Detrusor Overactivity

Asimakopoulos

Cerruto²,

Popolo³

et al. 2012

Urol Int

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“…As the patients suffering from NLUTS generally need a higher dose of anticholinergics than the patients with idiopathic detrusor overactivity, early discontinuation of the therapy due to adverse events is a potential drawback (Level of evidence: 1b, Grade of recommendation: A). Several antimuscarinic receptor antagonists have been investigated in the last three decades, and so far five antimuscarinic drugs (oxybutynin, trospium chloride, tolterodine, darifenacin and 14 are established effective medical treatments for NDO (Level of evidence: 1a, Grade of recommendation: A). Trospium chloride, a mixed antimuscarinic agent and a smooth muscle relaxant, is also a potential drug for neurogenic bladder management as it was shown to improve cystometric capacity and reduce incontinence episodes.…”

Section: Antimuscarinic Receptor Antagonistmentioning

confidence: 99%

Controversy over the pharmacological treatments of storage symptoms in spinal cord injury patients: a literature overview

et al. 2011

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Study design: Our aim was to locate research and communicate the evidence found from scientific studies pertaining to the treatment of neurogenic detrusor overactivity (NDO) in the chronic stage of spinal cord injury (SCI). Objective: To address the controversy over the traditional (antimuscarinics) and the 'new' treatments for NDO and try to offer an insight on the rationale underlying the development of new drugs such as botulinum toxin (BTX), vanilloids, nociceptin/orphanin FQ. As a final point, to provide information on a new class of cation channels, the Degenerin/Epithelial Na + Channel (Deg/ENaC) Family that could be future targets for the management of NDO. Setting: International. Methods: Overview of English literature on drug management of NDO. Results: Agents that block the 'efferent' function of micturition reflex, such as antimuscarinics, are currently first-line therapy for NDO. They reach the highest level of evidence (1a) and grade of recommendation (A). However, many patients and physicians believe that the 'efferent' pharmacological management of NDO is not completely satisfactory. Consequently, research is trying to address issues of efficacy, tolerability and convenience of new therapeutic strategies targeting the 'afferent' function. Conclusion: Antimuscarinic therapy increases the bladder capacity and delays the initial urge to void. However, in some patients they fail to achieve the patient's therapeutic goals. New interesting approaches have been investigated in the last few years. BTX seems to be very promising in treating neurogenic overactive bladder (OAB), but other compounds are now on the horizon.

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“…6 In children with myelodysplasia, there are two RCTs 7,8 and 11 observational studies. [9][10][11][12][13][14][15][16][17][18][19] Looking at all this evidence, propiverine, trospium, oxybutynin, propantheline and tolterodine have all been shown to produce clinical and some evidence of urodynamic improvement in NDO. Although this evidence is sufficient to conclude that "antimuscarinics are effective in NDO," prescribing more recently introduced antimuscarinics is not evidence-based.…”

Section: Antimuscarinic Therapy For Neurogenic Detrusor Overactivitymentioning

confidence: 99%

Systematic review of therapy for neurogenic detrusor overactivity

Fowler¹

2011

CUAJ

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While many neurologic diseases predispose patients to neurogenic detrusor overactivity (NDO), the only populations that have been systematically studied are adults with multiple sclerosis (MS), adults with spinal cord injury (SCI) and children and young adults with myelodysplasia. First-line pharmacotherapy for NDO is an antimuscarinic drug. However, the evidence base for these agents in this indication is poor. There is some high-quality evidence for the efficacy of detrusor injections of botulinum toxin A in the treatment of NDO, with significant reduction in urgency incontinence episodes, improved urodynamic parameters, and improved quality of life. While few adverse events have been reported with this therapy, there is a need for intermittent self-catheterization in these groups. N eurogenic detrusor overactivity (NDO) can be seen with various neurological diseases. At present, however, the only such populations that have been systematically studied are adults with multiple sclerosis (MS) and spinal cord injury (SCI) and children and young adults with myelodysplasia. There have yet to be any randomized, controlled studies evaluating therapy for NDO in Parkinson's Disease or dementia. This review will, therefore, focus on the available treatment evidence from the above-mentioned conditions. Antimuscarinic therapy for neurogenic detrusor overactivityThe first-line, mainstay treatment of NDO is the antimuscarinic drugs. This practice is not, however, based on a great deal of high quality research. Indeed, the body of evidence for their efficacy based on randomized controlled trials (RCTs) is surprisingly poor. In total, there are only five Grade-A studies in adults.1-5 These studies, which spanned from 1985 to 2007, examined the effect of oral propiverine, oxybutynin, trospium or propantheline or intravesical atropine. The research in MS has also been reviewed in a systematic fashion in a Cochrane review published in 2009. 6 In children with myelodysplasia, there are two RCTs 7,8 and 11 observational studies. 9-19Looking at all this evidence, propiverine, trospium, oxybutynin, propantheline and tolterodine have all been shown to produce clinical and some evidence of urodynamic improvement in NDO. Although this evidence is sufficient to conclude that "antimuscarinics are effective in NDO," prescribing more recently introduced antimuscarinics is not evidence-based. Rather, there is an assumption that their demonstrated efficacy in non-neurogenic DO is "carried over" to the NDO group. Indeed, everyday clinical experience does seem to bear that assumption out and even suggests that antimuscarinics may in fact be more efficacious in NDO than in idiopathic DO and that their benefits are longer lasting. Other oral therapies for neurogenic detrusor overactivity DesmopressinThe evidence for efficacy of desmopressin in MS for treatment of nocturia and daytime frequency is level 1, based on the results of a meta-analysis published in 2005. 20 However, desmopressin does carry the risk of hyponatremia, particularly ...

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Propiverine vs oxybutynin for treating neurogenic detrusor overactivity in children and adolescents: results of a multicentre observational cohort study

Cited by 25 publications

References 24 publications

An Overview on Mixed Action Drugs for the Treatment of Overactive Bladder and Detrusor Overactivity

An Overview on Mixed Action Drugs for the Treatment of Overactive Bladder and Detrusor Overactivity

Controversy over the pharmacological treatments of storage symptoms in spinal cord injury patients: a literature overview

Systematic review of therapy for neurogenic detrusor overactivity

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