Trospium Chloride for the Treatment of Detrusor Instability in Children

Pereira, P. López; Miguélez, Cristina; Caffarati, J.; Estornell, F.; A, Anguera Vila

doi:10.1097/01.ju.0000085667.05190.ad

Cited by 54 publications

(23 citation statements)

References 11 publications

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“…20 Aside from oxybutynin, which is FDA-approved for children, reports on use in children with OAB are provided for tolterodine, trospium and propiverine. [5][6][7][8][9][10][11][12] Hoebeke and colleagues performed a retrospective uncontrolled study in 138 children with therapy resistant non-neurogenic overactive bladder whom they treated with solifenacin for a mean of 23 months. They found solifenacin effective with an overall 85% response rate, a full response in more than 50% and side effects in only 6.5% of their cohort.…”

Section: Discussionmentioning

confidence: 99%

“…4 Data about the safety and efficacy of newer agents in children are scarce. Although there have been reports about the use of tolterodine, 5-9 trospium 10 and propiverine 11,12 in children, to date only oxybutynin chloride has been officially approved for pediatric use by medical authorities in North America. Solifenacin is a tertiary amine approved by the FDA for OAB in adults since 2005.…”

Section: Introductionmentioning

confidence: 99%

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Long-term use of solifenacin in pediatric patients with overactive bladder: Extension of a prospective open-label study

Nadeau

Schröeder

Moore

et al. 2014

CUAJ

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Introduction: We evaluate the efficacy and safety of solifenacin to treat incontinence in children with non-neurogenic (DO) or neurogenic detrusor overactivity (NDO) refractory to oxybutinin or tolterodine. Methods: We updated and extended our previously published nonrandomized uncontrolled study on open-label use of adjusted-dose regimens of solifenacin (1.25-10 mg) in children with refractory incontinence. The follow-up included voiding diaries, post-void residuals, urine cultures, ultrasounds and urodynamic studies. Clinical data were updated as of September 2012. Subjective improvement was assessed with the Patient Perception of Bladder Condition (PPBC) scale. The primary end point was efficacy toward continence and secondary end points were tolerability and safety. Results: Overall, 244 patients (112 girls, 132 boys) were enrolled; 53 with NDO and 191 with DO. Minimal follow-up was 5 months, the mean duration of treatment was 21.0 months and the mean age at initiation was 9.2 years. Urodynamic capacity improved from 145 ± 76 mL to 339 ± 152 mL and the amplitude of uninhibited contractions decreased from 66 ± 26 to 20 ± 20 cmH 2 O (p < 0.0001). The overall success rate is 91%, and more specifically 94% for non-neurogenic and 79% for neurogenic, which is significantly different (p = 0.013). Twenty-three patients discontinued treatment for unsatisfactory clinical response or bothersome side effects. No side effects were reported by 175 patients, mild by 46, moderate by 9, and 14 withdrew due to their side effects. Ten patients developed post-void residuals of ≥20 mL. Conclusion: Although higher in the non-neurogenic group, high subjective and objective success rates were maintained over a longer follow-up with an adjusted-dose regimen of solifenacin to treat pediatric NDO or DO refractory to oxybutynin or tolterodine. Moreover, we found acceptable tolerability and safety profiles.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term use of solifenacin in pediatric patients with overactive bladder: Extension of a prospective open-label study

Nadeau

Schröeder

Moore

et al. 2014

CUAJ

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“…It has been suggested, but not yet proven, that children suffering from severe side effects caused by tolterodine might benefit by a switch to other anticholinergic drugs such as propiverine or trospium chloride. Both have proved to be tolerable and efficacious as initial medication in children, but follow-up data are not yet available [18,19] .…”

Section: Discussionmentioning

confidence: 99%

Long-Term Efficacy of Tolterodine and Patient Compliance in Pediatric Patients with Neurogenic Detrusor Overactivity

et al. 2007

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Introduction: We investigated the effects of standard oral anticholinergic treatment with tolterodine in children with neurogenic bladder over a 5-year follow-up period and focused on treatment satisfaction, patient compliance and urodynamic parameters. Material and Methods: The follow-up consisted of regular visits and urodynamic evaluation at least once a year. The patients or their parents were interviewed to evaluate voiding behavior, as well as factors leading to lower patient compliance and deterioration in urodynamic parameters. Results: Of the 43 patients evaluated, 30 (70%) took their anticholinergic medication consistently and 13 (30%) sporadically. The mean bladder capacity was 354.7 ml in the first group but only 214.7 ml in the noncompliant group (p < 0.001). The mean maximal detrusor pressure decreased from 42.2 to 33.6 cm H₂O in the compliant group (p < 0.001) and from 49.7 to 46.4 cm H₂O in the noncompliant group (p = 0.21). The mean detrusor compliance increased from 18.9 to 19.3 ml/cm H₂O in the compliant group (p = 0.63) and from 11.8 to 12.3 ml/cm H₂O in the noncompliant group (p = 0.87). Side effects such as dry mouth (11/13) and dizziness (7/13) were common in the noncompliant group, whereas only 5/30 reported dry mouth in the compliant group. Conclusions: These data demonstrate the efficacy and tolerability of tolterodine over a long follow-up period. The results are promising in view of the fact that the patients will probably require life-long medication. Nevertheless, anticholinergic side effects still cause some patients to refuse regular medication, which results in a poorer urodynamic outcome.

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“…Kan-beyin bariyerini geçmediği için santral sinir sistemi üzerine asgari oranda etki göstermesi avantaj olarak bildirilmiştir. Çocuklarla ilgili veriler çok sınırlı olsa da, tek prospektif plasebo ile karşılaş-tırmalı çalışma, TCl'ye klinik yanıtın %82 olduğu ve %74 oranında ürodinami bulgularında iyileşme olduğu gösterilmiştir (38) .…”

Section: A Antikolinerjik Ilaç Tedavisiunclassified

Non-neuropathic bladder dysfunctions, and treatment approaches

Tuğtepe¹

2016

tcdd

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Trospium Chloride for the Treatment of Detrusor Instability in Children

Abstract: Trospium chloride (10 to 25 mg total daily dosage, split into 2 doses) is an effective option for the management of detrusor instability in children.

Cited by 54 publications

References 11 publications

Long-term use of solifenacin in pediatric patients with overactive bladder: Extension of a prospective open-label study

Long-term use of solifenacin in pediatric patients with overactive bladder: Extension of a prospective open-label study

Long-Term Efficacy of Tolterodine and Patient Compliance in Pediatric Patients with Neurogenic Detrusor Overactivity

Non-neuropathic bladder dysfunctions, and treatment approaches

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