Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

EVALUATION OF EVIDENCE BASED MEDICINE OF COMPARISONS USING THE SOLIFENACIN AND TOLTERODINE TO TREATMENT OVERACTIVE BLADDER

Author

Hu SF, Su HC, Lo CH

Institution

Department of pharmacy, Chi-Mei Medical Center, Tainan, Taiwan

Abstract

Objectives: The International Continence Society, ICS definition of overactive bladder (OAB) is a symptom complex that includes urinary urgency with or without urge incontinence, urinary frequency and nocturia. We want to evaluate efficacy and safety of following solifenacin versus tolterodine therapeutic for OAB symptom.

Methods: We used the PICO approach to generate an answerable question and searched databases including PubMed and Cochrane Library by using keywords of solifenacin and tolterodine and overactive bladder. The search was limited to humans, meta-analysis, and randomized controlled trial. The major outcome measures were urinary frequency, incontinence urodynamic effects and adverse event. We got one meta-analysis and two randomized controlled trial papers were included.

Results: The one of meta-analysis were primary aim evidence 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). Mean number of incontinence episodes. The results efficacy of solifenacin and tolterodine compared to placebo from systematic review,there were differences significant in improvements in OAB symptoms. The first randomized controlled trial of STAR study was conducted to compare the efficacy and safety of solifenacin 5/10mg and tolterodine ER 4mg in OAB patients. The results efficacy at 4 weeks means improvements in OAB symptoms, that solifenacin 5 mg vs. tolterodine ER 4 mg of mean reduction in incontinence episodes (24 hrs), reducing incontinence pad. Adverse event rate were dry mouth (18.2% vs. 15%), constipation (3.0% vs. 1.2%), blurred vision (0.2% vs. 1.5%). The second randomized controlled trial of efficacy in reducing the number of micturition, urgency and incontinence episodes per 24 hours. There was no difference in improvement of the quality of life. The incidence of major adverse events, including dry mouth (18.0% vs.8.3%, p = 0.31) and constipation (12.8% vs. 2.8%, p = 0.20) was not significantly different. Compared with baseline, the severity of dry mouth did not increase in either group.

Conclusion: There were no differences significant of comparisons using the solifenacin and tolterodine to treatment OAB of efficacy and safety.