DOCSLIB.ORG

Results: 5 Anticholinergic Medication Use for Female Overactive Bladder In

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Results: 5 Anticholinergic Medication Use for Female Overactive Bladder In darifenacin vs solifenacin - PubMed - NCBI Página 1 de 6 PubMed darifenacin vs solifenacin Display Settings: Abstract, Sorted by Recently Added Results: 5 Int Urogynecol J. 2013 Oct 25. [Epub ahead of print] 1. Anticholinergic medication use for female overactive bladder in the ambulatory setting in the United States. Ju R1, Garrett J, Wu JM. Author information Abstract INTRODUCTION AND HYPOTHESIS: Our objective was to estimate the prevalence and sociodemographic factors associated with anticholinergic medication use by adult women for overactive bladder (OAB) in the United States. METHODS: We conducted a cross-sectional study using the 2009 National Ambulatory Medical Care Survey database (NAMCS). We included women aged 18 years and older and identified visits for which anticholinergic medications for OAB were in active use. We evaluated the prevalence of medications used and estimated the use of short-acting versus long-acting drugs. We also assessed variables associated with anticholinergic use, (age, race/ethnicity, insurance, geographic location) using survey weights in the analysis to estimate national data. RESULTS: In 2009, adult women made 516.8 million outpatient office visits. Of these, 8.1 million (1.6 %) were associated with an OAB anticholinergic medication (annual rate 68 per 1,000 women). Women who used anticholinergics were predominantly insured by Medicare (61.0 %) and were older than those not using anticholinergic medications (70.0 ± 1.1 vs. 53.0 ± 0.5, p < 0.001). No racial or ethnic differences were evident between the two groups. Tolterodine (33.8 %) and oxybutynin (33.1 %) were the most commonly reported medications, followed by solifenacin (19.5 %), darifenacin (9.3 %), and trospium (4.4 %). Long-acting anticholinergics were used more often than short-acting medications (53.8 % vs. 46.3 %, respectively, p < 0.001). CONCLUSIONS: Annually, more than 8 million outpatient visits occur in which adult women in the United States are using an OAB anticholinergic medication. Despite the abundance of newer-generation medications, tolterodine and oxybutynin remain the most commonly prescribed anticholinergic drugs for OAB. Solifenacin is the most popular newer-generation anticholinergic drug. PMID: 24158462 [PubMed - as supplied by publisher] http://www.ncbi.nlm.nih.gov/pubmed 17/03/2014 darifenacin vs solifenacin - PubMed - NCBI Página 2 de 6 BJU Int. 2010 Aug;106(4):506-14. doi: 10.1111/j.1464-410X.2009.09160.x. Epub 2010 Feb 3. 2. The cost-effectiveness of solifenacin vs fesoterodine, oxybutynin immediate-release, propiverine, tolterodine extended-release and tolterodine immediate-release in the treatment of patients with overactive bladder in the UK National Health Service. Cardozo L1, Thorpe A, Warner J, Sidhu M. Author information Abstract OBJECTIVE: To assess the cost-effectiveness of solifenacin vs other antimuscarinic strategies commonly used in UK clinical practice, based on the results of a recent published review. METHODS: Overactive bladder (OAB) syndrome is characterized by symptoms of urgency, frequency, incontinence and nocturia. Pharmacological treatment comprises oral antimuscarinic agents, which are divided into older-generation treatments, including oxybutynin, and new-generation treatments, comprising solifenacin, tolterodine, darifenacin and fesoterodine. The latter have reduced central nervous system penetration and have better selectivity for the M3 subclass of acetylcholine receptors, resulting in improved tolerability. A recent systematic review and meta-analysis of the efficacy and safety of antimuscarinics provided an opportunity for an economic evaluation of these agents using a rigorous assessment of efficacy. A cost-utility analysis was undertaken using a 1-year decision-tree model. Treatment success was defined separately for urgency, frequency and incontinence, with efficacy data taken from the recent review. Treatment persistence rates were taken from the Information Management System database. Utility values for the calculation of quality-adjusted life-years (QALYs) were taken from published sources. The analysis included costs directly associated with treatment for OAB, i.e. antimuscarinic therapy, consultations with general practitioners, and outpatient contacts. Resource use was based on expert opinion. Costs were reported at 2007/2008 prices. Extensive deterministic and probabilistic analyses were conducted to test the robustness of the base-case results. RESULTS: Solifenacin was associated with the highest QALY gains (per 1000 patients) for all three outcomes of interest, i.e. urgency (712.3), frequency (723.1) and incontinence (695.0). Solifenacin was dominant relative to fesoterodine, tolterodine extended-release (ER) and tolterodine immediate-release (IR), and cost-effective relative to propiverine ER for urgency, frequency and incontinence. Solifenacin was not found to be cost-effective relative to oxybutynin IR for the frequency and incontinence outcomes, with an incremental cost- effectiveness ratio of > pound30,000/QALY threshold. CONCLUSIONS: http://www.ncbi.nlm.nih.gov/pubmed 17/03/2014 darifenacin vs solifenacin - PubMed - NCBI Página 3 de 6 Solifenacin provided the greatest clinical benefit and associated QALYs for all three outcomes of interest across all therapies considered, and to be either dominant or cost- effective relative to all other new-generation agents, but not cost-effective relative to oxybutynin for frequency and incontinence. Comment in The cost-effectiveness of solifenacin vs fesoterodine, oxybutynin immediate-release, propiverine, tolterodine extended-release and tolterodine immediate-release in the treatment of patients with overactive bladder in the UK National Health Service. [BJU Int. 2010] PMID: 20132203 [PubMed - indexed for MEDLINE] Publication Types, MeSH Terms, Substances Urologe A. 2009 Mar;48(3):245-9. doi: 10.1007/s00120-008-1915-y. 3. [Anticholinergic treatment of overactive bladder syndrome. Is it all the same?]. [Article in German] Schneider T1, Michel MC. Author information Abstract Anticholinergic therapy is the first-line therapy for overactive bladder (OAB) syndrome. Especially in the last years, the number of available substances has increased because of the launch of solifenacin, darifenacin, and fesoterodine. Additionally, slow-release and transdermal formulations have led to a large variety of available treatment options. The efficacy of all substances has been proven in randomised, double-blind studies, and reviews and meta-analyses have also underlined the efficacy of all available anticholinergics and have been updated regularly. All available drugs are efficacious for OAB treatment, and clinically relevant differences among them have not been proven consistently. Moreover, age, gender, and the type of OAB (dry vs. wet) seem to lack clinically relevant impact on the efficacy of OAB treatment. The various drugs are similar in tolerability, with the exception of more dry mouth and central nervous effects with slow-release oxybutynin. Knowledge of pharmacokinetic properties of the individual substances is important in order to choose the right therapy for each patient. PMID: 19145428 [PubMed - indexed for MEDLINE] http://www.ncbi.nlm.nih.gov/pubmed 17/03/2014 darifenacin vs solifenacin - PubMed - NCBI Página 4 de 6 Publication Types, MeSH Terms, Substances Eur Urol. 2008 Sep;54(3):543-62. doi: 10.1016/j.eururo.2008.06.047. Epub 2008 Jun 20. 4. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Chapple CR1, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D. Author information Abstract CONTEXT: Antimuscarinic agents are currently the first-line pharmacotherapy for overactive bladder. OBJECTIVES: A systematic review published in 2005 was updated, including data on a newly licensed antimuscarinic (fesoterodine). The primary aim of this study was to systematically review evidence on the efficacy of licensed administration of antimuscarinic treatments in overactive bladder from randomised controlled trials. Secondary aims were to review evidence on tolerability and safety and health-related quality of life (HRQL). EVIDENCE ACQUISITION: All relevant data sources from randomised controlled trials were searched, and two independent reviewers considered publications for inclusion and extracted relevant data. Meta-analysis was used to pool efficacy, tolerability, safety, and HRQL outcomes by treatment. Efficacy was measured by continent days, mean voided volume, urgency episodes, and micturition frequency. Tolerability and safety were measured by means of adverse event and withdrawal rates. HRQL was measured by various instruments. EVIDENCE SYNTHESIS: An additional 1118 references were retrieved with data on 83 studies extracted. Antimuscarinics were found to be more effective than placebo. Tolerability was good; few of the antimuscarinics were found to have significantly higher withdrawal rates in comparison to placebo. No serious adverse event for any product was statistically significant compared to placebo. Dry mouth (mild, moderate, severe) was the most commonly reported adverse event (29.6% on treatment vs 7.9% on placebo), followed by pruritus (15.4% on treatment vs 5.2% on placebo). Improvements were seen in HRQL with treatment by darifenacin, fesoterodine, oxybutynin transdermal delivery system, propiverine extended release (ER), solifenacin, tolterodine ER and immediate release, and trospium. Limitations of the study include restrictions on the
Load more

Recommended publications
  • The National Drugs List
    ^ ^ ^ ^ ^[ ^ The National Drugs List Of Syrian Arab Republic Sexth Edition 2006 ! " # "$ % &'() " # * +$, -. / & 0 /+12 3 4" 5 "$ . "$ 67"5,) 0 " /! !2 4? @ % 88 9 3: " # "$ ;+<=2 – G# H H2 I) – 6( – 65 : A B C "5 : , D )* . J!* HK"3 H"$ T ) 4 B K<) +$ LMA N O 3 4P<B &Q / RS ) H< C4VH /430 / 1988 V W* < C A GQ ") 4V / 1000 / C4VH /820 / 2001 V XX K<# C ,V /500 / 1992 V "!X V /946 / 2004 V Z < C V /914 / 2003 V ) < ] +$, [2 / ,) @# @ S%Q2 J"= [ &<\ @ +$ LMA 1 O \ . S X '( ^ & M_ `AB @ &' 3 4" + @ V= 4 )\ " : N " # "$ 6 ) G" 3Q + a C G /<"B d3: C K7 e , fM 4 Q b"$ " < $\ c"7: 5) G . HHH3Q J # Hg ' V"h 6< G* H5 !" # $%" & $' ,* ( )* + 2 ا اوا ادو +% 5 j 2 i1 6 B J' 6<X " 6"[ i2 "$ "< * i3 10 6 i4 11 6! ^ i5 13 6<X "!# * i6 15 7 G!, 6 - k 24"$d dl ?K V *4V h 63[46 ' i8 19 Adl 20 "( 2 i9 20 G Q) 6 i10 20 a 6 m[, 6 i11 21 ?K V $n i12 21 "% * i13 23 b+ 6 i14 23 oe C * i15 24 !, 2 6\ i16 25 C V pq * i17 26 ( S 6) 1, ++ &"r i19 3 +% 27 G 6 ""% i19 28 ^ Ks 2 i20 31 % Ks 2 i21 32 s * i22 35 " " * i23 37 "$ * i24 38 6" i25 39 V t h Gu* v!* 2 i26 39 ( 2 i27 40 B w< Ks 2 i28 40 d C &"r i29 42 "' 6 i30 42 " * i31 42 ":< * i32 5 ./ 0" -33 4 : ANAESTHETICS $ 1 2 -1 :GENERAL ANAESTHETICS AND OXYGEN 4 $1 2 2- ATRACURIUM BESYLATE DROPERIDOL ETHER FENTANYL HALOTHANE ISOFLURANE KETAMINE HCL NITROUS OXIDE OXYGEN PROPOFOL REMIFENTANIL SEVOFLURANE SUFENTANIL THIOPENTAL :LOCAL ANAESTHETICS !67$1 2 -5 AMYLEINE HCL=AMYLOCAINE ARTICAINE BENZOCAINE BUPIVACAINE CINCHOCAINE LIDOCAINE MEPIVACAINE OXETHAZAINE PRAMOXINE PRILOCAINE PREOPERATIVE MEDICATION & SEDATION FOR 9*: ;< " 2 -8 : : SHORT -TERM PROCEDURES ATROPINE DIAZEPAM INJ.
    [Show full text]
  • The Effects of Oral Administration of the Novel Muscarinic Receptor
    Choi et al. BMC Urology (2020) 20:41 https://doi.org/10.1186/s12894-020-00611-8 RESEARCH ARTICLE Open Access The effects of oral administration of the novel muscarinic receptor antagonist DA- 8010 on overactive bladder in rat with bladder outlet obstruction Jin Bong Choi1, Seung Hwan Jeon2, Eun Bi Kwon3, Woong Jin Bae4, Hyuk Jin Cho2, U-Syn Ha2, Sung-Hoo Hong2, Ji Youl Lee2 and Sae Woong Kim4* Abstract Background: DA-8010 is a novel compound developed for the treatment of overactive bladder (OAB) and urinary incontinence. The aims of this study were to investigate the effects of DA-8010 on OAB in a rat model. Methods: Study animals were divided into the following five groups of seven animals each: a sham-operated control group, a control group with partial bladder outlet obstruction (BOO) (OAB group), and three DA-8010 (doses of 0.3 mg/kg/day, 1 mg/kg/day, and 3 mg/kg/day, respectively) with partial BOO groups. Oral administration of the drugs was continued for 14 days after 2 weeks of partial BOO. After 4 weeks of partial BOO, cystometrography was performed in all groups. Additionally, pro-inflammatory cytokines, Rho-kinases, and histology of the bladder were analyzed. Results: There was a significant increase in the contraction interval and a decrease in contraction pressure in the 3 mg/kg/day DA-8010 group versus those in the OAB group. Rho kinase was also significantly decreased in the DA- 8010 3 mg/kg/day dosage treatment group. The increased ratio of collagen to smooth muscle after partial BOO was significantly attenuated in the DA-8010 3 mg/kg/day dosage group.
    [Show full text]
  • Anticholinergic Drugs Improve Symptoms but Increase Dry Mouth in Adults with Overactive Bladder Syndrome
    Source of funding: Evid Based Nurs: first published as 10.1136/ebn.6.2.49 on 1 April 2003. Downloaded from Review: anticholinergic drugs improve symptoms but Health Research Council of Aotearoa increase dry mouth in adults with overactive bladder New Zealand. syndrome For correspondence: Jean Hay-Smith, Hay-Smith J, Herbison P,Ellis G, et al. Anticholinergic drugs versus placebo for overactive bladder syndrome in adults. Dunedin School of Cochrane Database Syst Rev 2002;(3):CD003781 (latest version May 29 2002). Medicine, University of Otago, Dunedin, New QUESTION: What are the effects of anticholinergic drugs in adults with overactive Zealand. jean.hay-smith@ bladder syndrome? otago.ac.nz Data sources Parallel arm studies of anticholinergic drugs v placebo for overactive bladder syndrome in Studies were identified by searching the Cochrane adults at 12 days to 12 weeks* Incontinence Group trials register (to January 2002) Weighted event rates and reference lists of relevant papers. Anticholinergic Study selection Outcomes drugs Placebo RBI (95% CI) NNT (CI) Randomised or quasi-randomised controlled trials in Self reported cure or adults with symptomatic diagnosis of overactive bladder improvement (8 studies) 63% 45% 41% (29 to 54) 6 (5 to 8) syndrome, urodynamic diagnosis of detrusor overactiv- RRI (CI) NNH (CI) ity, or both, that compared an anticholinergic drug Dry mouth (20 studies) 36% 15% 138 (70 to 232) 5 (4 to 7) (given to decrease symptoms of overactive bladder) with Outcomes Weighted mean difference (CI) placebo or no treatment. Studies of darifenacin, emepronium bromide or carrageenate, dicyclomine Number of leakage episodes in 24 hours (9 − chloride, oxybutynin chloride, propiverine, propanthe- studies) 0.56 (–0.73 to –0.39) Number of micturitions in 24 hours (8 studies) −0.59 (–0.83 to –0.36) line bromide, tolterodine, and trospium chloride were Maximum cystometric volume (ml) (12 studies) 54.3 (43.0 to 65.7) included.
    [Show full text]
  • Package Leaflet
    Version 4, 02/2016 Propigen 5 mg coated tablets v005common PACKAGE LEAFLET 1 PACKAGE LEAFLET: INFORMATION FOR THE USER PROPIGEN 5 MG COATED TABLETS (PROPIVERINE HYDROCHLORIDE) Read all of this leaflet carefully before you or your child start taking this medicine because it contains important information for you. - Keep this leaflet. You may need to read it again. - If you have any further questions, ask your doctor or your pharmacist. - This medicine has been prescribed for you or your child, respectively, only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours or your child’s. - If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet (see section 4). The name of your medicine is Propigen 5 mg. The active substance is propiverine hydrochloride and the other ingredients are listed at the end of the leaflet (section 6, Contents of the pack and other information). What is in this leaflet: 1. What Propigen 5 mg is and what it is used for 2. What you need to know before you or your child take Propigen 5 mg 3. How to take Propigen 5 mg 4. Possible side effects 5. How to store Propigen 5 mg 6. Contents of the pack and other information 1. WHAT PROPIGEN 5 MG IS AND WHAT IT IS USED FOR Propigen 5 mg is used for the treatment of adults and children who have difficulty in controlling their bladder due to bladder overactivity or, in some cases, problems with the spinal cord.
    [Show full text]
  • Pharmaceutical Appendix to the Tariff Schedule 2
    Harmonized Tariff Schedule of the United States (2007) (Rev. 2) Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE HARMONIZED TARIFF SCHEDULE Harmonized Tariff Schedule of the United States (2007) (Rev. 2) Annotated for Statistical Reporting Purposes PHARMACEUTICAL APPENDIX TO THE TARIFF SCHEDULE 2 Table 1. This table enumerates products described by International Non-proprietary Names (INN) which shall be entered free of duty under general note 13 to the tariff schedule. The Chemical Abstracts Service (CAS) registry numbers also set forth in this table are included to assist in the identification of the products concerned. For purposes of the tariff schedule, any references to a product enumerated in this table includes such product by whatever name known. ABACAVIR 136470-78-5 ACIDUM LIDADRONICUM 63132-38-7 ABAFUNGIN 129639-79-8 ACIDUM SALCAPROZICUM 183990-46-7 ABAMECTIN 65195-55-3 ACIDUM SALCLOBUZICUM 387825-03-8 ABANOQUIL 90402-40-7 ACIFRAN 72420-38-3 ABAPERIDONUM 183849-43-6 ACIPIMOX 51037-30-0 ABARELIX 183552-38-7 ACITAZANOLAST 114607-46-4 ABATACEPTUM 332348-12-6 ACITEMATE 101197-99-3 ABCIXIMAB 143653-53-6 ACITRETIN 55079-83-9 ABECARNIL 111841-85-1 ACIVICIN 42228-92-2 ABETIMUSUM 167362-48-3 ACLANTATE 39633-62-0 ABIRATERONE 154229-19-3 ACLARUBICIN 57576-44-0 ABITESARTAN 137882-98-5 ACLATONIUM NAPADISILATE 55077-30-0 ABLUKAST 96566-25-5 ACODAZOLE 79152-85-5 ABRINEURINUM 178535-93-8 ACOLBIFENUM 182167-02-8 ABUNIDAZOLE 91017-58-2 ACONIAZIDE 13410-86-1 ACADESINE 2627-69-2 ACOTIAMIDUM 185106-16-5 ACAMPROSATE 77337-76-9
    [Show full text]
  • Marrakesh Agreement Establishing the World Trade Organization
    No. 31874 Multilateral Marrakesh Agreement establishing the World Trade Organ ization (with final act, annexes and protocol). Concluded at Marrakesh on 15 April 1994 Authentic texts: English, French and Spanish. Registered by the Director-General of the World Trade Organization, acting on behalf of the Parties, on 1 June 1995. Multilat ral Accord de Marrakech instituant l©Organisation mondiale du commerce (avec acte final, annexes et protocole). Conclu Marrakech le 15 avril 1994 Textes authentiques : anglais, français et espagnol. Enregistré par le Directeur général de l'Organisation mondiale du com merce, agissant au nom des Parties, le 1er juin 1995. Vol. 1867, 1-31874 4_________United Nations — Treaty Series • Nations Unies — Recueil des Traités 1995 Table of contents Table des matières Indice [Volume 1867] FINAL ACT EMBODYING THE RESULTS OF THE URUGUAY ROUND OF MULTILATERAL TRADE NEGOTIATIONS ACTE FINAL REPRENANT LES RESULTATS DES NEGOCIATIONS COMMERCIALES MULTILATERALES DU CYCLE D©URUGUAY ACTA FINAL EN QUE SE INCORPOR N LOS RESULTADOS DE LA RONDA URUGUAY DE NEGOCIACIONES COMERCIALES MULTILATERALES SIGNATURES - SIGNATURES - FIRMAS MINISTERIAL DECISIONS, DECLARATIONS AND UNDERSTANDING DECISIONS, DECLARATIONS ET MEMORANDUM D©ACCORD MINISTERIELS DECISIONES, DECLARACIONES Y ENTEND MIENTO MINISTERIALES MARRAKESH AGREEMENT ESTABLISHING THE WORLD TRADE ORGANIZATION ACCORD DE MARRAKECH INSTITUANT L©ORGANISATION MONDIALE DU COMMERCE ACUERDO DE MARRAKECH POR EL QUE SE ESTABLECE LA ORGANIZACI N MUND1AL DEL COMERCIO ANNEX 1 ANNEXE 1 ANEXO 1 ANNEX
    [Show full text]
  • Comparision Effects of Solifenacin, Darifenacin, Propiverine on Ocular Parameters in Eyes: a Prospective Study ______
    ORIGINAL ARTICLE Vol. 46 (2): 185-193, March - April, 2020 doi: 10.1590/S1677-5538.IBJU.2019.0094 Comparision effects of solifenacin, darifenacin, propiverine on ocular parameters in eyes: A prospective study _______________________________________________ Mahmut Taha Ölçücü 1, Kerem Teke 1, Kadir Yildirim 2, Mesut Toğaç 3, Burcu Işık 3, Yusuf Cem Yilmaz 3 1 Department of Urology, Agri State Hospital, Agri, Turkey; 2 Department of Urology, Elaziğ Education and Research Hospital, Elazig, Turkey; 3 Department of Ophthalmology, Agri State Hospital, Agri, Turkey ABSTRACT ARTICLE INFO Objective: To evaluate the effects of solifenacin, darifenacin, and propiverine on Mahmut Taha Ölçücü nasal-, subfoveal-, temporal choroidal thicknesses (NCT, SFCT, TCT), intraocular http://orcid.org/0000-0002-4721-2807 pressure (IOP) and pupil diameter (PD). Materials and Methods: Patients with overactive bladder (OAB) diagnosed accord- Keywords: ing to The International Continence Society were administered with solifenacin, Pressure; Urinary Bladder; darifenacin or propiverine on a daily basis between November 2017 and May 2018. Overactive; Anisocoria NCT, SFCT, TCT, IOP, and PD of these patients were measured and compared as Int Braz J Urol. 2020; 46: 185-93 initial, fourth and twelfth weeks. Results: A total of 165 patients (330 eyes) with OAB were evaluated. Solifenacin (n=140) signifi cantly reduced IOP from 17.30±2.72 mmHg to 16.67±2.56 mmHg _____________________ (p=0.006) and 16.57±2.41 mmHg (p=0.002), at the fourth and twelfth weeks, re- Submitted for publication: spectively. Darifenacin (n=110) signifi cantly reduced NCT from 258.70±23.96 μm February 08, 2019 to 257.51±22.66 μm (p=0.002) and 255.36±19.69 μm (p=0.038), at the fourth and _____________________ twelfth weeks, respectively.
    [Show full text]
  • 202 Which Anticholinergic Drug for Adults With
    202 Madhuvrata P1, Singh M2, Abdel-Fattah M3 1. Sheffield Teaching Hospital,UK, 2. Sheffield Teaching Hospital, UK, 3. University of Aberdeen, UK WHICH ANTICHOLINERGIC DRUG FOR ADULTS WITH NEUROGENIC DETRUSOR OVERACTIVITY? A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED TRIALS Hypothesis / aims of study We aim to compare the efficacy, tolerability and safety of one anticholinergic drug versus another and also higher doses of anticholinergics versus lower dose in the treatment of adult neurogenic detrusor overactivity (NDO). Study design, materials and methods : Literature search of MEDLINE, EMBASE, Cochrane incontinence specialised trials register, clinicaltrials.gov and IUGA/ICS conference abstract databases was performed from 1966 to January 2011. Randomised trials (RTs) comparing one anticholinergic drug with other or two doses of the same anticholinergic drug, in adults with NDO were included. Trials comparing anticholinergics versus placebo were excluded. Data were extracted independently by two authors. Data was analysed using Rev-Man 5. The primary outcome was the clinical cure/ improvement; both patient-reported cure and objective cure. The secondary outcomes were quality of life (Qol), Overactive bladder symptoms (urinary frequency/24hrs, urgency/24hrs, incontinence/24hrs), Urodynamic outcomes (maximum cystometric capacity, maximum detrusor contraction, number of detrusor contractions, residual volume), adverse events (dry mouth) and withdrawals due to adverse events. Fig1: Oxybutynin vs other AC- Change in frequency/24hrs
    [Show full text]
  • Factors Associated with Decisions for Initial Dosing, Up-Titration of Propiverine and Treatment Outcomes in Overactive Bladder S
    Journal of Clinical Medicine Article Factors Associated with Decisions for Initial Dosing, Up-Titration of Propiverine and Treatment Outcomes in Overactive Bladder Syndrome Patients in a Non-Interventional Setting Marjan Amiri 1,2 , Tim Schneider 3, Matthias Oelke 4, Sandra Murgas 5 and Martin C. Michel 6,* 1 Institute of Medical Informatics, Biometry and Epidemiology, University Hospital Essen, 45130 Essen, Germany; [email protected] 2 Center for Clinical Trials Essen (ZKSE), University Hospital Essen, 45130 Essen, Germany 3 Praxisklinik Urologie Rhein-Ruhr, 45468 Mülheim, Germany; [email protected] 4 Department of Urology, St. Antonius Hospital, 48599 Gronau, Germany; [email protected] 5 Apogepha, 01309 Dresden, Germany; [email protected] 6 Department of Pharmacology, Johannes Gutenberg University, 55131 Mainz, Germany * Correspondence: [email protected]; Tel.: +49-6131-179346 Abstract: Two doses of propiverine ER (30 and 45 mg/d) are available for the treatment of overactive bladder (OAB) syndrome. We have explored factors associated with the initial dosing choice (allo- cation bias), the decision to adapt dosing (escalation bias) and how dosing relative to other factors affects treatment outcomes. Data from two non-interventional studies of 1335 and 745 OAB patients, respectively, receiving treatment with propiverine, were analyzed post-hoc. Multivariate analysis was applied to identify factors associated with dosing decisions and treatment outcomes. Several Citation: Amiri, M.; Schneider, T.; parameters were associated with dose choice, escalation to higher dose or treatment outcomes, but Oelke, M.; Murgas, S.; Michel, M.C. only few exhibited a consistent association across both studies. These were younger age for initial Factors Associated with Decisions for dose choice and basal number of urgency and change in incontinence episodes for up-titration.
    [Show full text]
  • Pharmacological Treatment of Urinary Incontinence
    Committee 8 Pharmacological Treatment of Urinary Incontinence Chairman KARL-ERIK ANDERSSON (USA) Co-Chairman C. R CHAPPLE (U.K) Members L. CARDOZO (U.K), F. C RUZ (Portugal), H. HASHIM (U.K), M.C. MICHEL (The Netherlands), C. TANNENBAUM (Canada), A.J. WEIN (USA) 631 CONTENTS A. INTRODUCTION X. OTHER DRUGS I. PUBLICATION SEARCHES XI. COMBINATIONS II. CENTRAL NERVOUS CONTROL XII. FUTURE POSSIBILITIES III.PERIPHERALNERVOUS CONTROL C.DRUGS USED FOR IV. PATHOGENESIS OF BLADDER TREATMENT OF STRESS CONTROL DISORDERS URINARY INCONTINENCE V. BLADDER CONTRACTION I. α-ADRENCEPTOR AGONISTS VI. MUSCARINIC RECEPTORS II. β-ADRENOCEPTOR ANTAGONISTS B. DRUGS USED FOR TREATMENT OF OVERACTIVE III. β-ADRENOCEPTOR AGONISTS BLADDER SYMPTOMS/ DETRUSOR OVERACTIVITY IV. SEROTONIN-NORADRENALINE UPTAKE INHIBITORS I. ANTIMUSCARINIC (ANTICHOLINERGIC) DRUGS D.DRUGS USED FOR II. DRUGS ACTING ON MEMBRANE TREATMENT OF CHANNELS OVERFLOW INCONTINENCE III. DRUGS WITH “MIXED” ACTION E. HORMONALTREATMENT OF URINARY INCONTINENCE IV. α-ADRENOCEPTOR (AR) ANTAGONISTS I. ESTROGENS V. β-ADRENOCEPTOR AGONISTS II. OTHER STEROID HORMONE VI. PHOSPHODIESTERASE (PDE) RECEPTOR LIGANDS INHIBITORS III. DESMOPRESSIN VII. ANTIDEPRESSANTS VIII. CYCLOOXYGENASE (COX) INHIBITORS F. CONSIDERATIONS IN THE ELDERLY IX. TOXINS REFERENCES 632 Pharmacological Treatment of Urinary Incontinence KARL-ERIK ANDERSSON C. R CHAPPLE, L. CARDOZO, F. CRUZ, H. HASHIM, M.C. MICHEL, C. TANNENBAUM, A.J. WEIN Table 1. ICI assessments 2008: Oxford guidelines (modified) A. INTRODUCTION Levels of evidence Level 1: Systematic reviews, meta-analyses, good The function of the lower urinary tract (LUT) is to store quality randomized controlled clinical trials and periodically release urine, and is dependent on (RCTs) the activity of smooth and striated muscles in the Level 2: RCTs , good quality prospective cohort bladder, urethra, and pelvic floor.
    [Show full text]
  • Pharmacological Interventions for Bladder Dysfunction in Multiple Sclerosis: a Systematic Literature Review
    Pharmacological Interventions for Bladder Dysfunction In Multiple Sclerosis: A Systematic Literature Review Katelyn Sohor, B.Sc., PA-S [email protected] Supervisor: Dr. Ruth Ann Marrie A capstone project submitted to the Faculty of Graduate Studies of The University of Manitoba in partial fulfillment of the requirements for the degree of MASTER OF PHYSICIAN ASSISTANT STUDIES University of Manitoba May 9, 2016 1 Abstract Background: As many as 75% of multiple sclerosis (MS) patients experience urinary symptoms during the course of their disease, which can affect many aspects of their daily life.28 Though effective pharmacological treatment for bladder dysfunction exists, effectiveness in the MS population has not been adequately reviewed. Objective: To identify, appraise, and synthesize data to determine efficacy of current pharmacological treatments for bladder dysfunction, specifically overactive bladder in patients with MS. Methods: We searched the Cochrane Database for related systemic reviews, in addition to searching the following databases for randomized controlled trials: PubMed, Medline [OVID], EMBASE [OVID], and Cochrane Central Register of Controlled Trials. Databases were searched from inception date to December 15th, 2015. We used comprehensive Cochrane review search terms for Medline, EMBASE, and the Cochrane central register. Two reviewers independently screened titles, abstracts, and full text articles to ensure all studies were randomized controlled trials, that results for MS patients were presented separately if the study had also included other patients with bladder dysfunction, and that the outcomes of interest were reported. We included studies meeting the following criteria: (1) prospective, and randomized controlled trials conducted in any setting; (2) published in English; (3) conducted on adult patients with a diagnosis of MS and experiencing bladder dysfunction, as defined by health professional or self reported symptoms; (4) Studies that examined any pharmacological therapy for treatment of bladder dysfunction in MS patients.
    [Show full text]
  • Management of Parkinson's Disease: an Evidence-Based Review
    Movement Disorders Vol. 17, Suppl. 4, 2002, p. i 2002 Movement Disorder Society Published by Wiley-Liss, Inc. DOI 10.1002/mds.5554 Editorial Management of Parkinson’s Disease: An Evidence-Based Review* Although Parkinson’s disease is still incurable, a large number tomatic control of Parkinson’s disease; prevention of motor com- of different treatments have become available to improve quality plications; control of motor complications; and control of non- of life and physical and psychological morbidity. Numerous jour- motor features. Based on a systematic review of the data, efficacy nal supplements have appeared in recent years highlighting one conclusions are provided. On the basis of a narrative non-system- or more of these and disparate treatment algorithms have prolifer- atic approach, statements on safety of the interventions are given ated. Although these are often quite useful, this “mentor analy- and finally, a qualitative approach is used to summarize the impli- sis” approach lacks the scientific rigor required by modern evi- cations for clinical practice and future research. dence-based medicine standards. The Movement Disorder Soci- This mammoth task has taken two years to complete and the ety, with generous but unrestricted support from representatives task force members, principal authors and contributors are to be of industry, have, therefore, commissioned a systematic review congratulated for their outstanding work. Physicians, the of the literature dealing with the efficacy and safety of available Parkinson’s disease research community and most of all patients treatments. The accompanying treatise is the result of a scrupu- themselves should welcome and embrace the salient findings of lous evaluation of the literature aimed at identifying those treat- this report as an effort to improve clinical practice.
    [Show full text]