Fesoterodine fumarate (Toviaz) appears to reduce urge incontinence in patients with overactive bladder who had a suboptimal response to tolterodine tartrate extended release (Detrol LA), according to a phase IV study.
The 14-week randomized, placebo-controlled, double-blind multicenter study assessed fesoterodine, 8 mg, in patients with OAB who had been taking tolterodine, 4 mg, for 2 weeks and had less than 50% reduction in urge urinary incontinence episodes. After open-label treatment with tolterodine, 4 mg, treatment with fesoterodine, 4 mg, was started for 1 week, followed by treatment with fesoterodine, 8 mg.
The study results demonstrated that fesoterodine, 4 mg, for 1 week followed by fesoterodine, 8 mg, statistically significantly reduced the average number of urge urinary incontinence episodes (-2.37 episodes from baseline) per 24 hours (p<.0001) in OAB patients who had a suboptimal response to tolterodine, 4 mg. The safety and tolerability profiles of fesoterodine and tolterodine were consistent with previous studies. The most common treatment-emergent adverse events for both fesoterodine and tolterodine were dry mouth and constipation.
“This study adds to the body of evidence supporting fesoterodine as an effective treatment for patients with overactive bladder, including patients who may not have responded to tolterodine,” said principal investigator Steven A. Kaplan, MD, of New York-Presbyterian Hospital/Weill Cornell Medical Center, New York. “Health care professionals often question how to treat patients who have had a suboptimal response to tolterodine, which is commonly used but does not have a dose higher than 4 mg, and these data may help to guide treatment decisions.”
Drug treatments for urge incontinence are used alongside bladder re-training.
Overactive bladder also known as urge incontinence is the second most common type of incontinence. When someone can’t control the urge to urinate or urinates involuntarily, this person has an overactive bladder.
An overactive bladder contracts involuntarily, leading to the release of large amounts of urine. This is caused by a problem with the messages between the bladder and the brain. The bladder may tell the brain it is full too early, the bladder muscle squeezes and empties the bladder completely – often before you have a chance to get to a toilet.
The first thing to do when you notice the above symptoms is to seek help; this condition is treatable if diagnosed early.
Common questions asked by the doctor include:
• How many times do you urinate during the day?
• How often do you urinate after going to sleep?
• Are you awakened by the urge to urinate, and if so, how often?
• When you have a strong urge to urinate, do you leak urine on the way to the toilet, and if so, how often?
• Do you use incontinence pads, and if so, how many do you use daily?
• Does the problem prevent or affect any activity?
Don’t’ be surprised if your doctor asks you to keep a dairy of your urinating habits.
There are different ways for managing OAB. They include medicines, behavioural interventions and surgery.
Treatment methods will depend on the severity of the condition, and the extent to which it affects the patient’s quality of life.
In general patients with an overactive bladder are treated with a combination of drugs and behavioural interventions like pelvic floor exercises.
Above all, overactive bladder or urge incontinence is nothing to be ashamed of and it is treatable, so stop suffering in silence.