Well-Tolerated Tolterodine Cuts Incontinence Episodes In Half In Overactive Bladder Patients

Dr. Harold Drutz, University of Toronto, Canada, Dr. Paul Abrams, Bristol Urological Institute, UK, et. al. found that patients treated with tolterodine achieved significant improvements in incontinence episodes, frequency of micturition (urination) and amount of urine voided per micturition.

"In the past, therapy for overactive bladder has been limited to drugs with poor tolerability, leading to low compliance or early discontinuation of treatment," says Drutz, Professor and Head, Section of Urogynecology, Department of Ob/Gyn, University of Toronto and Head, Urogynecology, Mount Sinai Hospital. "This study confirms that tolterodine is very effective in reducing incontinence episodes, and offers improved tolerability for long-term treatment of overactive bladder. As a result, tolterodine increases patient satisfaction and compliance."

Overactive bladder is a serious, chronic disease that effects 50 million people worldwide of all ages. Despite its prevalence, 80 percent of those suffering with overactive bladder are not under a physician's care. Many sufferers fail to seek medical help because they mistakenly believe, or are even told by physicians, that bladder control problems are an inevitable part of aging and nothing can be done to help. Sufferers are also too embarrassed to talk about their problem with a physician.

Researchers studied 2,220 patients who were enrolled in 2-, 4-, or 12-week double-blind, placebo-controlled studies with tolterodine or placebo. Of this group, seventy-five percent of patients (a total of 1,669) elected to continue on long-term open-label treatment with tolterodine 2 mg BID. Incontinence episodes were significantly reduced (p<0.0001) from 3.2 at baseline to 1.6 after 12 months of treatment with tolterodine. Of interest, thirty-five percent of the 1669 patients who participated in the study experienced poor efficacy on other treatments.

Compared to other drugs used to treat overactive bladder, tolterodine is selective for bladder tissue over salivary gland tissue in the body, thus reducing the incidence of dry mouth, the most common side effect. The severity of dry mouth reported during the study was low and not troublesome to patients. Only four percent discontinued the study because of treatment-associated dry mouth. A total of 66 percent of patients (a total of 1106) completed 12 months of treatment with tolterodine.

Overactive bladder is marked by symptoms of frequency, urgency, with or without urge incontinence. Frequency means urinating more than eight times within a 24-hour period, while urgency is a sudden, overwhelming urge to urinate. Urge incontinence is the sudden and involuntary loss of urine, which may often follow the sense of urgency. Only forty percent of people with overactive bladder experience urge incontinence. This study was sponsored by Pharmacia & Upjohn.