Symptom-specific efficacy of tolterodine extended release in patients with overactive bladder: the IMPACT trial

Abstract

We evaluated the efficacy of tolterodine extended release (ER) for patients' most bothersome overactive bladder (OAB) symptom in a primary care setting. Patients with OAB symptoms for >or=3 months received tolterodine ER (4 mg q.d.) for 12 weeks. Among incontinent patients (n = 772), the most bothersome OAB symptoms were daytime frequency (28%), urgency urinary incontinence (UUI; 27%), nocturnal frequency (26%) and urgency (19%); among continent patients (n = 91), they were daytime frequency (47%), nocturnal frequency (42%) and urgency (10%). Sixty-nine per cent of patients had one or more comorbid conditions. By week 12, there were significant reductions in patients' most bothersome symptom: -80% for UUI, -78% for urgency episodes, -40% for nocturnal frequency and -30% for daytime frequency (p < 0.0001). The most common adverse events were dry mouth (10%) and constipation (4%). In primary care practice, bothersome OAB symptoms can be effectively and safely treated with tolterodine ER, even in patients with comorbid conditions.

Solifenacin for Overactive Bladder: Patient-Reported Outcomes from a Large Placebo-Controlled Trial

“…20 In VENUS, significantly more patients taking solifenacin than placebo showed improvement on the PPBC. Similar PPBC results have been demonstrated in other studies of solifenacin, 11 tolterodine, 31 and darifenacin. 11,31,32 On the OAB-q, the magnitude of the change scores reached or exceeded the MID in both groups, suggesting that patients perceived meaningful changes in symptom bother and HRQL.…”

Efficacy of tolterodine in relation to different urodynamic findings of detrusor overactivity

“…With this hypothesis, we found a significant difference in tolterodine 4-mg ER efficacy between the two groups, with women showing DO during the filling phase having a better efficacy. In this latter group of patients, the efficacy of tolterodine was high (86%) and comparable to what reported in the IMPACT study by Elinoff et al [6].…”

“…Quite recently, Elinoff et al [6] reported the results of the IMPACT study which assessed the efficacy of tolterodine 4 mg extended release in treating OAB in a primary care setting. Even if this study shows some of the best results ever published on this issue reaching up to 78% in the reduction of urgency and 80% of urge incontinence, there is still a proportion of subjects who are not improved or cured after treatment.…”

The treatment of overactive bladder: A primary care provider’s perspective

“…In the fi rst study, they measured the effi cacy of an antimuscarinic in the treatment of OAB, and in the second they used patient-reported outcomes to see if that was a realistic way to evaluate the success of medication in this population. They proved that the treatment of OAB can be simple, safe, and successful [13]. This approach should be a key part of the education the urologist provides to the PCP.…”