Randomised, Multicentre, Placebo-controlled, Double-blind Crossover Study Investigating the Effect of Solifenacin and Oxybutynin in Elderly People with Mild Cognitive Impairment: The SENIOR Study

Wagg, Adrian; Dale, Mark; Tretter, Reiner; Stow, Bridget; Compion, Gerhard

doi:10.1016/j.eururo.2013.01.002

Cited by 118 publications

(85 citation statements)

References 28 publications

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“…In a chronic-dosing, three-way crossover study of solifenacin 5 mg, placebo, and oxybutynin immediate-release 5 mg twice daily in 24 healthy volunteers with mild cognitive impairment, no discernible effect of either solifenacin or oxybutynin versus placebo could be detected at similar time points. However, at a pooled time point, likely to cover the C max for each drug, oxybutynin was associated with impairments in speed of attention and reaction time, whereas no effect could be observed for solifenacin versus placebo [76]. A cross-over study of tolterodine extended release 4 mg versus oxybutynin extended release, titrated to 20 mg once daily, in 22 healthy cognitively intact older subjects found no effect after 3 weeks of treatment with tolterodine when compared with placebo on the Name-Face Association test, but a significant deterioration in oxybutynin-treated subjects.…”

Section: Bladder Antimuscarinics and Cognitioncontrasting

confidence: 46%

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

et al. 2015

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Urinary incontinence and lower urinary tract symptoms are highly prevalent in late life and are strongly associated with dementia and frailty. Incontinence is extremely common among those living in long-term care and is most commonly due to urgency incontinence. Although national and international guidelines for continence care exist, they often fail to consider the complex comorbidity found in patients with dementia and are often not followed; continence practices in long-term care may promote rather than prevent incontinence. The majority of those with dementia living in the community can be managed successfully with standard treatments, both pharmacological and non-pharmacological; the expectations and aims of treatment of both the patient and their caregivers should be considered. A dementia diagnosis does not preclude management of incontinence, but treatment options may be more limited in those with advanced dementia who are unable to retain information and modify behaviors. High-quality data to guide the choice of pharmacological agent in those with dementia are lacking. Oxybutynin has been shown to have significant adverse cognitive effects, but data to support the use of trospium, solifenacin, darifenacin, and fesoterodine are limited. No data are available for mirabegron. Neither age, frailty, nor dementia should be considered a barrier to pharmacological management, but consideration should be given to the total anticholinergic load. Evidence to guide the treatment of incontinence in this vulnerable patient group is scarce, and available guidelines adapted for each individual's situation should be applied.

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Section: Bladder Antimuscarinics and Cognitioncontrasting

confidence: 46%

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

et al. 2015

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“…Furthermore, medications with a larger molecular size are less likely to cross the blood-brain barrier, thereby reducing the risk of cognitive dysfunction. 16,17 Sustained-release anticholinergic medication options (longacting oral or transdermal patch formulations) can also decrease the side effects typically associated with rapidrelease formulations, because plasma blood levels can be maintained more consistently without the variability found with oral, regularly acting oxybutynin formulations.…”

Section: Treatment Goals and Therapeutic Optionsmentioning

confidence: 99%

Neurogenic overactive bladder in spinal cord injury and multiple sclerosis: role of onabotulinumtoxinA

Ethans¹,

Casey²,

Bard³

et al. 2014

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People with neurogenic overactive bladder from either multiple sclerosis or spinal cord injury often suffer significant morbidity and decreased quality of life. Here we review the pathophysiology of neurogenic overactive bladder and the impact it can have on people with multiple sclerosis or spinal cord injury. We also address the various traditional treatment options and focus on the use of botulinum toxin A (specifically onabotulinumtoxinA) for this condition.

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“…[44][45][46] At the NICE CG 171, it is stated that oxybutynin IR should not be prescribed to frail older women. 15 It has also been hypothesized that more rapid functional deterioration might result from the combined use of cholinesterase inhibitors with antimuscarinic agents in elderly patients with cognitive dysfunction.…”

Section: Antimuscarinic Treatmentmentioning

confidence: 99%

“…The same authors developed a randomized, double-blind, placebocontrolled, triple crossover study-the SENIOR study-to assess the cognitive effects of solifenacin and oxybutynin in subjects older than 75 years with mild cognitive impairment. 45 They evaluate extensively short-term cognitive effects of once-daily solifenacin 5 mg and twice-daily oxybutynin 5 mg. Subjects were randomized in six groups, with different sequences to receive solifenacin, oxybutynin, and placebo.…”

mentioning

confidence: 99%

Treatment of Overactive Bladder in Elderly Patients: Clinical Considerations

2015

Clinical Medicine Insights: Geriatrics

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Overactive bladder (OAB) is a highly prevalent disorder among elderly and frail elderly patients, who are frequently polymedicated, suffer from kidney and liver failure and are susceptible to adverse events. Particular attention is, therefore, being given to efficacy and side effects of the treatment in patients older than 75 years. The introduction of newly developed drugs specifically designed for the treatment of OAB is opening new frontiers on this respect. The authors summarize the most recent evidence on this topic.

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Randomised, Multicentre, Placebo-controlled, Double-blind Crossover Study Investigating the Effect of Solifenacin and Oxybutynin in Elderly People with Mild Cognitive Impairment: The SENIOR Study

Cited by 118 publications

References 28 publications

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

Managing Urinary Incontinence in Patients with Dementia: Pharmacological Treatment Options and Considerations

Neurogenic overactive bladder in spinal cord injury and multiple sclerosis: role of onabotulinumtoxinA

Treatment of Overactive Bladder in Elderly Patients: Clinical Considerations

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