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European Urology
Volume 48, issue 1, pages 1-178, July 2005Review - Overactive Bladder
The Effects of Antimuscarinic Treatments in Overactive Bladder: A Systematic Review and Meta-Analysis
Accepted 24 February 2005, Published online 22 March 2005, pages 5 - 26
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Abstract
Objectives:
To evaluate the tolerability, safety and efficacy of antimuscarinic drugs used to treat overactive bladder and to identify any differences between individual antimuscarinics.
Methods:
Medline, Embase, CCTR and Cinahl databases were searched for published RCTs including an antimuscarinic agent from 1966 to August 2004. Data from included trials were extracted and meta-analysed where possible.
Results:
Fifty-six trials were included. The antimuscarinics were found to be safe and efficacious. All antimuscarinics apart from oxybutynin IR were found to be well tolerated. Dry mouth was the most commonly reported adverse event and no drug was associated with an increase in any serious adverse event. There were significant differences between the antimuscarinics in rates of withdrawal and rates and range of adverse events and efficacy outcomes.
Conclusions:
The antimuscarinics have different tolerability and safety profiles, which are clinically significant.
Keywords: (A)trial published in abstract form only, AEany adverse event, ANMFthe number of patients achieving normal micturition frequency, ASAEany serious adverse event, BOObladder outlet obstruction, CCTControlled Clinical Trial, CCTRCochrane Controlled Trials Register, CIconfidence interval, CIEmean change in incontinence episodes per 24 hours, CMmean change in the number of micturitions per 24 hours, CUEmean change in the number of urgency episodes per 24 hours, CVVmean change in volume voided per micturition, dardarifenacin, DOdetrusor overactivity, ERextended release, ICIInternational Consultation on Incontinence, ICSInternational Continence Society, IIQIncontinence Impact Questionnaire, IRimmediate release, ITTintention to treat, IUGAInternational Urogynaecological Association, KHQKing's Health Questionnaire, LUTDlower urinary tract disease, LUTlower urinary tract, MImixed incontinence, nnumber of patients included in the analysis, NRnot reported, OABoveractive bladder, OBJECTOveractive Bladder: Judging Effective Control and Treatment, OPERAOveractive Bladder: Performance of Extended Release Agents, oxyoxybutynin, Pplacebo, PPper protocol, propropiverine, PROpatient reported outcome, QoLquality of life, RCthe number of patients returned to continence, RCTrandomised controlled trial, RRrelative risk ratio, SF-36Short-form 36, SF-12Short-form 12, SIUSocieté Internationale d’Urologie, solsolifenacin, SUIstress urinary incontinence, (t)titrated dose, (t 5)titrated from 5 mg/day, (t 7.5)titrated from 7.5 mg/day, (t 15)titrated from 15 mg/day, TDStransdermal system, toltolterodine, trotrospium, UDIUrogenital Distress Inventory, UIurinary incontinence, UTIurinary tract infection, UUIurge urinary incontinence, VASvisual analog scale, WMDweighted mean difference, WOCNWound Ostomy Continence Nurses’ Society, (X)trial was of cross-over design, Antimuscarinic, Overactive bladder, Detrusor overactivity, Incontinence, Systematic review, Meta-analysis.
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