Literature DB >> 20151972

Fesoterodine in patients with overactive bladder syndrome: can the severity of baseline urgency urinary incontinence predict dosing requirement?

Linda Cardozo1, Vik Khullar, Joseph T Wang, Zhonghong Guan, Peter K Sand.   

Abstract

OBJECTIVES: To determine whether baseline urgency urinary incontinence (UUI) episodes predict the need for increased doses of fesoterodine in patients with overactive bladder (OAB), as clinicians would benefit from data that help to predict which patients require higher doses of antimuscarinics to manage UUI episodes. PATIENTS AND METHODS: In this pooled analysis of data from two double-blind, placebo-controlled trials, patients were randomized to placebo or fesoterodine 4 or 8 mg for 12 weeks and stratified into tertiles (>0-<2, 2-<4, or > or =4) according to the number of UUI episodes/24 h as recorded in 3-day bladder diaries at baseline. The change in mean UUI episodes/24 h from baseline to end of study was assessed using analysis of covariance.
RESULTS: In a post hoc analysis of data from two clinical trials, there were significant reductions from baseline in UUI episodes for fesoterodine 4 and 8 mg vs placebo in patients (n) with >0-<2 (422), 2-<4 (424) and > or =4 (481) UUI episodes at baseline (all P < 0.01). In patients with 2-<4 and > or =4 UUI episodes at baseline, fesoterodine 8 mg gave significantly greater mean reductions (-1.92 and -4.17, respectively) vs fesoterodine 4 mg (-1.43 and -3.31) (P < 0.05). The most common adverse events were dry mouth (placebo, 8%; fesoterodine 4 mg, 19%; and 8 mg, 35%) and constipation (placebo, 2%; fesoterodine 4 mg, 5%; and 8 mg, 6%).
CONCLUSION: Fesoterodine 4 and 8 mg significantly reduced UUI episodes vs placebo; this effect appeared to be greater with fesoterodine 8 mg in patients with > or =2 UUI episodes/24 h at baseline. Fesoterodine was well tolerated, although higher doses increased the incidence of adverse events. These findings might aid the clinical identification of patients with OAB who would most benefit from increasing the dose of fesoterodine from 4 to 8 mg.

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Year:  2010        PMID: 20151972     DOI: 10.1111/j.1464-410X.2010.09202.x

Source DB:  PubMed          Journal:  BJU Int        ISSN: 1464-4096            Impact factor:   5.588


  5 in total

1.  Cost-effectiveness analysis of fesoterodine flexible dose in newly diagnosed patients with overactive bladder in routine clinical practice in Spain.

Authors:  Carmen Peral; Francisco Sánchez-Ballester; José M García-Mediero; Jaime Ramos; Javier Rejas
Journal:  Clinicoecon Outcomes Res       Date:  2016-09-26

Review 2.  Dealing with complex overactive bladder syndrome patient profiles with focus on fesoterodine: in or out of the EAU guidelines?

Authors:  John Heesakkers; Montserrat Espuña Pons; Philip Toozs Hobson; Emmanuel Chartier-Kastler
Journal:  Res Rep Urol       Date:  2017-10-31

3.  Expert Opinion on Three Clinical Cases with a Common Urgent Problem: Urge Urinary Incontinence.

Authors:  Andrea Tubaro; John Heesakkers; Jean Nicolas Cornu; Dudley Robinson
Journal:  Case Rep Urol       Date:  2018-10-16

4.  Urinary Urgency: A Symptom In Need Of A Cure.

Authors:  Stefano Salvatore; Montserrat Espuña-Pons; Andrea Tubaro
Journal:  Res Rep Urol       Date:  2019-12-09

5.  Effect of baseline symptom severity on continence improvement mediated by oxybutynin chloride topical gel.

Authors:  Peter K Sand; Scott A Macdiarmid; Heather Thomas; Kim E Caramelli; Gary Hoel
Journal:  Open Access J Urol       Date:  2011-10-19
  5 in total

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