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Scott Martin Vouri, Mario Schootman, Seth A Strope, Stanley J Birge, Margaret A Olsen
BACKGROUND: Oral oxybutynin has been associated with the development of cognitive impairment. OBJECTIVE: The objective of this study was to describe the use of oral oxybutynin versus other antimuscarinics (e.g., tolterodine, darifenacin, solifenacin, trospium, fesoterodine, transdermal oxybutynin) in older adults with documented cognitive impairment. METHODS: This is a population-based retrospective analysis of antimuscarinic new users aged ≥ 66 years from January 2008 to December 2011 (n = 42,886) using a 5% random sample of Medicare claims linked with Part D data...
February 28, 2018: Drugs & Aging
Yuwei Zhao, Jing Zhou, Qian Mo, Yang Wang, Jinna Yu, Zhishun Liu
BACKGROUND: Overactive bladder is stated as the occurrence of urinary urgency which will cause negative impacts and decrease patients' health-related quality of life. The aim of this systematic review is to assess the efficiency and safety of acupuncture for adults with overactive bladder (OAB) comparing with sham-acupuncture, drugs, and acupuncture plus drugs. METHODS: We independently searched 9 databases from beginning to August 15, 2017. Two writers extracted data at the same time independently...
February 2018: Medicine (Baltimore)
Sarah A Morrow, Heather Rosehart, Alp Sener, Blayne Welk
Bladder dysfunction is common in persons with MS (PwMS), often due to detrusor muscle overactivity. Anticholinergic medications are considered the first line treatment for bladder dysfunction and are known to worsen cognition in healthy older adults and in persons with dementia. Yet, it is not known if these medications have the same effect on PwMS. Thus, the Objective of this prospective matched-cohort study was to determine if anticholinergic medications affect objective measures of cognition in PwMS. We recruited PwMS starting either oxybutynin or tolterodine (cases)...
February 15, 2018: Journal of the Neurological Sciences
J Schliessbach, A Siegenthaler, L Bütikofer, P Vuilleumier, P Jüni, U Stamer, L Arendt-Nielsen, M Curatolo
BACKGROUND: Drugs are prescribed for chronic low back pain without knowing in advance whether a patient will respond to them or not. Quantitative sensory tests (QST) can discriminate patients according to sensory phenotype, possibly reflecting underlying mechanisms of pain processing. QST may therefore be a screening tool to identify potential responders to a certain drug. The aim of this study was to investigate whether QST can predict analgesic effects of oxycodone, imipramine and clobazam in chronic low back pain...
January 23, 2018: European Journal of Pain: EJP
Jesper Hallas, Andrea V Margulis, Anton Pottegård, Nina Sahlertz Kristiansen, Willem Jan Atsma, Kwame Appenteng, Stefan de Vogel, James A Kaye, Susana Perez-Gutthann, Alejandro Arana
The purpose of this study was to estimate the incidence rate (IR) of 10 common cancers in new users of antimuscarinic overactive bladder (OAB) medications. We conducted a cohort study using data recorded in Danish registers for patients newly exposed to the OAB drugs darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine or trospium in years 2004-2012, aged ≥18 years and without cancer before treatment initiation. We estimated IRs for each study cancer (bladder, breast, colorectal, lung, melanoma, non-Hodgkin lymphoma, pancreas, prostate, renal and uterine), standardised by age and sex and explored IR trends over time since treatment initiation...
January 17, 2018: Basic & Clinical Pharmacology & Toxicology
Masayo Oishi, Yuma Takano, Yutaka Torita, Bimal Malhotra, Koji Chiba
This study was conducted to estimate in vivo inhibition constant (Ki) of ketoconazole on renal P-glycoprotein (P-gp) using human drug-drug interaction (DDI) study result of fesoterodine and ketoconazole. Fesoterodine is a prodrug which is extensively hydrolyzed by non-specific esterases to the active metabolite 5-hydroxymethyl tolterodine (5-HMT). 5-HMT is then further metabolized via Cytochrome P450 (CYP) 2D6 and CYP3A4. It is reported that 5-HMT is a substrate of P-gp whereas fesoterodine is not. Renal clearance of 5-HMT is approximately two-times greater than renal glomerular filtration rate...
November 15, 2017: Drug Metabolism and Pharmacokinetics
Mina Tadrous, Dean Elterman, Wayne Khuu, Muhammad M Mamdani, David N Juurlink, Tara Gomes
INTRODUCTION: Medication is an important option for patients with overactive bladder (OAB), with four different drugs approved over the last 10 years including the first non-anticholinergic treatment, mirabegron. We set out to describe the number and rate of users of medication for the management of OAB over the last 15 years among residents of Ontario, Canada covered by the public drug programs. METHODS: We conducted a population-based, repeated cross-sectional study examining quarterly publically-funded prescription claims for OAB medications from January 2000 to June 2016 in Ontario, Canada...
December 22, 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
Ali B Goodson, Matthew A Cantrell, Robert F Shaw, Brian C Lund
BACKGROUND: Limited data from short-term clinical trials suggest efficacy advantages of solifenacin and fesoterodine over other anticholinergic agents in the treatment of lower urinary tract symptoms. OBJECTIVES: To (a) determine the real-world comparative effectiveness of newer anticholinergic agents for lower urinary tract symptoms, as assessed by 1-year persistence, and (b) identify patient factors independently associated with persistence. METHODS: We conducted a retrospective cohort study of U...
January 2018: Journal of Managed Care & Specialty Pharmacy
Alan C Kinlaw, Michele Jonsson Funk, Mitchell M Conover, Virginia Pate, Alayne D Markland, Jennifer M Wu
BACKGROUND: Despite several new medications being Food and Drug Administration-approved for overactive bladder (OAB) and new prescription drug payment programs, there are limited population-based data regarding OAB medication use among older adults. OBJECTIVES: To examine: (1) impacts of new medications and $4 generic programs on time trends for OAB-related medication dispensing for older adults in the United States; (2) differences by age and sex; and (3) temporal changes in OAB-related medication payments...
December 28, 2017: Medical Care
Robab Maghsoudi, Saeed Farhadi-Niaki, Masoud Etemadian, Amir H Kashi, Pejman Shadpour, Asemaneh Shirani, Rana Samadinezhad-Khoshbaf-Sorkhabi, Meghdad Tabatabaei
PURPOSE: The purpose of this study was to compare the efficacy of tolterodine and gabapentin vs placebo in catheter related bladder discomfort (CRBD) following percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: This study was a double-blind parallel group randomized clinical trial. Patients who were candidates of PCNL were enrolled. Patients were randomized to treatment groups of tolterodine 2 mg orally (PO) (group T, n = 50), gabapentin 600 mg PO (group G, n = 50), and placebo (group P, n = 70) 1 hour before operation using balanced block randomization...
February 2018: Journal of Endourology
Arcangelo Sebastianelli, Giorgio I Russo, Steven A Kaplan, Kevin T McVary, Ignacio Moncada, Stavros Gravas, Christopher Chapple, Giuseppe Morgia, Sergio Serni, Mauro Gacci
A systematic review and meta-analysis was carried out to evaluate the efficacy and safety of mirabegron 50 mg and 100 mg in the treatment of storage lower urinary tract symptoms/overactive bladder in comparison with a placebo and tolterodine 4 mg. A total of 491 articles were collected and eight randomized studies were identified as eligible for this meta-analysis. Overall, eight trials were included in the meta-analysis evaluating 10 248 patients. Mirabegron at both doses of 50 mg and 100 mg, and and tolterodine 4 mg were significantly associated with the reduction of incontinence episodes per 24 h, reduction of mean number of micturitions per 24 h, increase of voided volume and reduction of urgency episodes per 24 h, compared to a placebo...
December 3, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
Qiang Liu, Deyi Luo, Tongxin Yang, Banghua Liao, Hong Li, Kun-Jie Wang
BACKGROUND/AIMS: Overactive bladder associated with bladder outlet obstruction (BOO) is a highly prevalent condition, which is usually treated with antimuscarinics. However, the potential effects of antimuscarinics on the structure and function of bladder have not been investigated thus far. METHODS: Sprague-Dawley(R) rats accepted bladder neck obstruction surgery or sham surgery, and then received treatment of three different antimuscarinics (Solifenacin, Darifenacin, and Tolterodine) or vehicle...
2017: Cellular Physiology and Biochemistry
Ji-Yeong Byeon, Young-Hoon Kim, Se-Hyung Kim, Choong-Min Lee, Chang-Ik Choi, Jung-Woo Bae, Choon-Gon Jang, Seok-Yong Lee, Yun Jeong Lee
Tolterodine, a nonselective muscarinic antagonist available only as immediate release (IR) or extended release (ER) oral formulations, is used for the treatment of overactive bladder (OAB). This study aimed to compare the efficacy and extent of dry mouth adverse effects of tolterodine transdermal patch to the oral formulation. The two formulations have been examined through the muscarinic receptor binding tests conducted in bladder and salivary gland tissues and the salivary secretion tests conducted in rats...
December 2017: Archives of Pharmacal Research
Jameel Nazir, Con Kelleher, Samuel Aballéa, Khaled Maman, Zalmai Hakimi, Colette Mankowski, Isaac Odeyemi
AIMS: To compare efficacy and tolerability of solifenacin 5 mg/day versus other oral antimuscarinic agents for the treatment of overactive bladder (OAB). METHODS: Literature searches of MEDLINE, Embase, and the Cochrane Library were undertaken to identify randomized controlled trials in OAB (2000-2015) for antimuscarinic agents. A network meta-analysis (NMA) was performed to estimate efficacy and tolerability outcomes for solifenacin 5 mg/day relative to other antimuscarinics...
November 15, 2017: Neurourology and Urodynamics
Andrea V Margulis, Jesper Hallas, Anton Pottegård, Nina Sahlertz Kristiansen, Willem Jan Atsma, Billy Franks, Milbhor D'Silva, Cristina Varas-Lorenzo, Susana Perez-Gutthann, Alejandro Arana
PURPOSE: The purpose of this study is to explore the cardiovascular safety of antimuscarinic drugs to treat overactive bladder (OAB) in Denmark. METHODS: This was a cohort study using data recorded in Danish registries from patients newly exposed to darifenacin, fesoterodine, oxybutynin, solifenacin, tolterodine, or trospium in 2004-2012. We estimated crude and standardized incidence rates (IRs) for acute myocardial infarction (AMI); stroke; cardiovascular mortality; major adverse cardiac events (MACE, a combined endpoint of the previous three outcomes); and all-cause death for the individual and combined drugs...
February 2018: European Journal of Clinical Pharmacology
Young-Hoon Kim, Ji-Yeong Byeon, Se-Hyung Kim, Choong-Min Lee, Eui Hyun Jung, Won Ki Chae, Choon-Gon Jang, Seok-Yong Lee, Yun Jeong Lee
Tolterodine is a nonselective muscarinic antagonist that is indicated for the overactive urinary bladder and other urinary difficulties. We developed and validated a simple, rapid and sensitive high-performance liquid chromatography analytical method utilizing tandem mass spectrometry (LC-MS/MS) for the quantitation of tolterodine and its major metabolites, 5-hydroxymethyltolterodine (5-HMT) and N-dealkyltolterodine (NDT), in human plasma. After liquid-liquid extraction with methyl t-butyl ether, chromatographic separation of the three analytes was achieved using a reversed-phase Luna Phenyl-hexyl column (100 × 2...
November 2017: Archives of Pharmacal Research
Eman I El-Kimary, Essam F Khamis, Saeid F Belal, Mona M Abdel Moneim
A validated and selective high-performance thin-layer chromatography (HPTLC) method was developed for the analysis of mixures of tamsulosin hydrochloride (TAM) with either tolterodine tartrate (TOL) or solifenacin succinate (SOL) in bulk drug and in combined dosage forms. The proposed method is based on HPTLC separation of the three drugs followed by densitometric measurements of their spots at 224 nm. Separation was carried out on Merck HPTLC aluminum sheets of silica gel 60 F254 using ethyl acetate-methanol-ammonia (6:4:0...
September 11, 2017: Journal of Chromatographic Science
Rajan Rajabalaya, Chung Yee Mun, Jestin Chellian, Srikumar Chakravarthi, Sheba R David
The purpose of the study was to develop a transdermal tolterodine tartrate (TT) patch and to analyse its efficacy for overactive bladder (OAB) treatment. Patches were prepared using various polymers and plasticizers via the solvent casting method. The patches were characterized for tensile strength, thickness, moisture content, modulus of elasticity and water absorption capacity. Differential scanning calorimetry and Fourier transform infrared analyses were also performed. To determine patch effectiveness, in vitro release, permeation and animal studies were performed...
September 1, 2017: Acta Pharmaceutica
Daisuke Kato, Satoshi Uno, James Van Schyndle, Alan Fan, Tomomi Kimura
OBJECTIVES: To evaluate persistence and adherence to mirabegron and antimuscarinics in Japan using data from two administrative databases. METHODS: The present retrospective study evaluated insurance claims for employees and dependents aged ≤75 years, and pharmacy claims for outpatients. From October 2012 to September 2014, new users of mirabegron or five individual antimuscarinics indicated for overactive bladder in Japan (fesoterodine, imidafenacin, propiverine, solifenacin and tolterodine) were identified and followed for 1 year...
August 22, 2017: International Journal of Urology: Official Journal of the Japanese Urological Association
Jian-Liang Cai, Wei-Min Yao, Yan-Qun Na
BACKGROUND: Whether cholinergic innervations and/or autophagy have a role in the etiopathology of benign prostatic hyperplasia (BPH) is still unknown. This study aimed to investigate the role of cholinergic innervation and autophagy in the etiopathology of BPH. METHODS: Male, 13-week-old spontaneous hypertension rats (spontaneous BPH animal model) were divided into three groups: an experimental group (EG, n = 24), a control group (CG, n = 24), and a normal control group (NC, n = 10)...
August 20, 2017: Chinese Medical Journal
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